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Individual

DIANE A VESTAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTA/L

Contact information

Practice address
1320 WINDLASS DR, BALTIMORE, MD 21220-4100
(410) 918-2139
Mailing address
311 TAPLOW RD, BALTIMORE, MD 21212-3540
(410) 530-1645

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A00725
MD

Other

Enumeration date
12/17/2015
Last updated
12/17/2015
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