Individual
BLONDELL MIRANDA DALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8007 15TH AVE APT 8007, ADELPHI, MD 20783-4804
(240) 204-0518
Mailing address
8007 15TH AVE APT 8007, ADELPHI, MD 20783-4804
(240) 204-0518
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
19004382
VA
225700000X
Massage Therapist
Primary
M05441
MD
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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