Individual
MISS VENECIA CRISTAL IFILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
515 BRIGHTFIELD RD, LUTHERVILLE, MD 21093-3643
(410) 832-2398
Mailing address
12 SADDLETOP CT APT A, COCKEYSVILLE, MD 21030-4046
(443) 834-2858
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05599
MD
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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