Individual
ALLISON RETTALIATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2725 MAPLE AVE, PARKVILLE, MD 21234-5610
(317) 361-9966
Mailing address
2725 MAPLE AVE, PARKVILLE, MD 21234-5610
(317) 361-9966
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008986900
—
MD
05
—
100282840
—
MD
Enumeration date
09/05/2022
Last updated
09/05/2022
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