Individual
STACEY AURELIA ELDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LE, CPE
Contact information
Practice address
6600 YORK RD STE 209, BALTIMORE, MD 21212-2024
(410) 235-2211
(443) 991-4320
Mailing address
6600 YORK RD STE 209, BALTIMORE, MD 21212-2024
(410) 235-2211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
EO1288
MD
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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