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Individual

RENIE EFUETNGU LEKE TAZISONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
7067 COLUMBIA GATEWAY DR STE 180, COLUMBIA, MD 21046-3408
(410) 929-7225
(443) 333-5434
Mailing address
5609 PINE BLUFF CT, FREDERICK, MD 21704-6894
(240) 728-5997

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
AC004226
MD

Other

Enumeration date
03/23/2022
Last updated
08/08/2024
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