Individual
MARY VIRGINIA BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9716 WOODYARD CIR, UPPER MARLBORO, MD 20772-4390
(704) 612-1836
Mailing address
9716 WOODYARD CIR, UPPER MARLBORO, MD 20772-4390
(704) 612-1836
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23472679
DRIVER LICENSE
NC
Enumeration date
03/13/2018
Last updated
03/13/2018
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