Individual
LATOYA SHALLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 618-7121
Mailing address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(240) 893-8766
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R187274
MD
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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