Individual
MIA C TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 MEDSTAR BLVD STE 325, BEL AIR, MD 21015-1817
(410) 877-8078
Mailing address
800 WHITE PINE LN, JOPPA, MD 21085-4346
(240) 858-9879
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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