Individual
TIARRA HURSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3701 WOODHAVEN AVE, BALTIMORE, MD 21216-1520
(410) 240-7586
Mailing address
3701 WOODHAVEN AVE, BALTIMORE, MD 21216-1520
(410) 240-7586
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
82-4068616
MD
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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