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Individual

GLADYS TOMBISE EKEMA MOSASO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
7120 MINSTREL WAY, SUITE 203, COLUMBIA, MD 21045-5292
(508) 979-5557
Mailing address
9201 EDGEWORTH DR UNIT 3412, CAPITOL HEIGHTS, MD 20791-7505

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R210280
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R210280
MBON
MD
Enumeration date
09/30/2020
Last updated
12/18/2024
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