Individual
ITA M SHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10712 MARIETTA ST, GLENN DALE, MD 20769-9405
(240) 510-4293
Mailing address
10712 MARIETTA ST, GLENN DALE, MD 20769-9405
(240) 510-4293
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA200003055
DC
Other
Enumeration date
01/29/2024
Last updated
02/03/2025
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