Individual
LISA MAUREEN PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
431 E RIDGEVILLE BLVD, MOUNT AIRY, MD 21771-5217
(301) 829-6811
Mailing address
511 JERMOR LN, SUITE B, WESTMINSTER, MD 21157-6151
(410) 876-8076
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18434
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160584
UNITED HEALTHCARE
—
01
—
543042-04
BCBS OF MARYLAND
—
01
—
7914198
AETNA
—
01
—
T208
BLUECHOICE/GHMSI
—
Enumeration date
12/21/2006
Last updated
05/16/2008
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