Individual
SHAUNTE MONET HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
1130 COOKS LN, BALTIMORE, MD 21229
(410) 365-5018
Mailing address
1130 COOKS LN, BALTIMORE, MD 21229-1232
(410) 365-5018
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
5000-609
MD
291U00000X
Clinical Medical Laboratory
5000-609
MD
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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