Individual
TENNILLE LISETTE BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
704 SNOWDON LN, GLEN BURNIE, MD 21061-4824
(443) 416-6119
Mailing address
704 SNOWDON LN, GLEN BURNIE, MD 21061-4824
(443) 416-6119
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
5000000001145548
MD
Other
Enumeration date
08/13/2017
Last updated
07/21/2022
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