Individual
TAHIRA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14929 NOTLEY RD, SILVER SPRING, MD 20905-5821
(240) 444-9603
Mailing address
14929 NOTLEY RD, SILVER SPRING, MD 20905-5821
(240) 444-9603
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
MD
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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