Individual
TYRAHNA JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRANIAL PROSTHESIS
Contact information
Practice address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(410) 304-3127
Mailing address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(410) 304-3127
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
174400000X
Specialist
—
—
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
06/07/2016
Last updated
08/14/2023
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