Individual
MISS BRUNETTE ORNELLA BOUTAYO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6307 BARRS LN, LANHAM, MD 20706-2841
(240) 889-0679
Mailing address
6307 BARRS LN, LANHAM, MD 20706-2841
(240) 889-0679
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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