Individual
MS. WATTA D BUNDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201
(410) 328-8667
Mailing address
7108 24TH PL, HYATTSVILLE, MD 20783-2705
(301) 257-5311
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
23324
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255840823
—
MD
Enumeration date
09/26/2017
Last updated
07/02/2018
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