Individual
KAMALA DJUANA VIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5601 LOCH RAVEN BLVD, SUITE 406, BALTIMORE, MD 21239-2905
(443) 444-8000
Mailing address
5601 LOCH RAVEN BLVD, SUITE 406, BALTIMORE, MD 21239-2905
(443) 444-8000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R151745
MD
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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