Individual
MARTHA TANESHA HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
3407 FORT MEADE RD STE 14, LAUREL, MD 20724-2003
(240) 898-6523
Mailing address
8777 CONTEE RD APT 304, LAUREL, MD 20708-1936
(240) 421-2872
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
423537
MD
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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