Individual
MRS. MARISUE DIANE DOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
105 W CHESAPEAKE AVE, TOWSON, MD 21204-4725
(443) 809-3660
Mailing address
6901 N CHARLES ST, TOWSON, MD 21204-3780
(443) 809-3660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
013709-1
NY
225100000X
Physical Therapist
Primary
28655
MD
Other
Enumeration date
07/11/2011
Last updated
01/11/2022
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