Individual
MRS. NINA NICOLE VALLECILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
10 N GREENE ST, BALTIMORE, MD 21201-1524
(410) 935-6786
Mailing address
10709 MEYERS LN, WHITE MARSH, MD 21162-1927
(410) 935-6786
Taxonomy
Speciality
Code
Description
License number
State
2471C1101X
Cardiovascular-Interventional Technology Radiologic Technologist
Primary
R0007012
MD
Other
Enumeration date
06/21/2017
Last updated
06/21/2017
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