Individual
MARY N TITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6812 RED TOP RD, #1, TAKOMA PARK, MD 20912-5908
(240) 715-2749
Mailing address
6812 RED TOP RD, #1, TAKOMA PARK, MD 20912-5908
(240) 715-2749
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
T300587628577
MD
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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