Individual
REBECCA JEAN ILLINGWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 S HANOVER ST, BALTIMORE, MD 21225-1233
(410) 353-9202
Mailing address
3001 S HANOVER ST, BALTIMORE, MD 21225-1233
(410) 353-9202
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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