Individual
KRISTEN IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6201 FRANKFORD AVE, BALTIMORE, MD 21206-4903
(410) 396-9294
Mailing address
200 E NORTH AVE, BALTIMORE, MD 21202-4888
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
07460
MD
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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