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Individual

BWANG FULE MARTHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1800 METZEROTT RD APT 307, ADELPHI, MD 20783-5104
(360) 499-1307
Mailing address
14723 RING HOUSE RD, BRANDYWINE, MD 20613-2042
(360) 499-1307

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
05/16/2023
Last updated
06/05/2023
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