Individual
GAVASA MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
348 KENDIG DR, OWINGS MILLS, MD 21117-1371
(410) 992-2122
Mailing address
348 KENDIG DR, OWINGS MILLS, MD 21117-1371
(410) 992-2122
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
30AL1262
MD
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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