Individual
JENNA NICOLE DAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
504 E RIDGEVILLE BLVD, MOUNT AIRY, MD 21771-5942
(301) 703-5452
Mailing address
8604 WATKINS RUN CT, ELLICOTT CITY, MD 21043-1952
(410) 361-0951
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0007244
MD
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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