Individual
DILYS BURG TICHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14151 CASTLE BLVD APT 402, SILVER SPRING, MD 20904-4779
(240) 316-2241
Mailing address
14151 CASTLE BLVD APT 402, SILVER SPRING, MD 20904-4779
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-200-143-101-653
DRIVER'S LICENSE
MD
Enumeration date
05/08/2019
Last updated
07/05/2019
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