Individual
DIONDELLA BLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11641 DORADO BEACH CT, WALDORF, MD 20602-3123
(502) 650-3179
Mailing address
11641 DORADO BEACH CT, WALDORF, MD 20602-3123
(502) 650-3179
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
04794
MD
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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