Individual
MADISON SALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2319 HANOVER PIKE, HAMPSTEAD, MD 21074-1137
(410) 374-0925
Mailing address
19731 GRAVE RUN RD, HAMPSTEAD, MD 21074-2729
(443) 823-8393
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
09554
MD
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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