Individual
MS. ANGELIQUE LYNETTE VAILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3510 65TH AVE UNIT 10F, HYATTSVILLE, MD 20784-2464
(240) 375-1670
Mailing address
3510 65TH AVE UNIT 10F, HYATTSVILLE, MD 20784-2464
(240) 375-1670
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
118206
MD
Other
Enumeration date
10/10/2018
Last updated
02/17/2021
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