Individual
NIDA HENNESSEY CORRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(386) 341-2770
Mailing address
186 S HALIFAX DR, ORMOND BEACH, FL 32176-6533
(386) 341-2770
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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