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PATRICIA MAFORNGWAHFOR TALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9135 PISCATAWAY RD STE 410, CLINTON, MD 20735-2555
(240) 643-1063
Mailing address
10203 BIRDIE LN, UPPER MARLBORO, MD 20774-6068
(240) 486-2745

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R224410
MD

Other

Enumeration date
06/03/2024
Last updated
06/03/2024
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