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Individual

MR. MICHAEL ANTONIO RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNA/GNA

Contact information

Practice address
5457 TWIN KNOLLS RD STE 300, COLUMBIA, MD 21045-3296
(800) 301-6326
Mailing address
5457 TWIN KNOLLS RD STE 300, COLUMBIA, MD 21045-3296
(800) 301-6326

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
A00062099
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
66882
PASSENGEER-FOR-HIRE DRIVER'S LICENSETRANSPORTATION
MD
Enumeration date
01/30/2025
Last updated
02/09/2025
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