Individual
MRS. MARY ELIZABETH OLDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12611 WESTPORT LN, WOODBRIDGE, VA 22192-3417
(919) 721-2693
Mailing address
12611 WESTPORT LN, WOODBRIDGE, VA 22192-3417
(919) 721-2693
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
03/30/2013
Last updated
04/14/2017
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