Individual
JENNA MICHONG SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7141 SECURITY BLVD, BALTIMORE, MD 21244-1811
(443) 663-6223
(443) 663-6131
Mailing address
8111 BROOKWOOD FARM RD, FULTON, MD 20759-9658
(443) 663-6223
(443) 663-6131
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
R100864
MD
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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