Individual
MARTHA TADESSE CHONCHORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
18842 BROKEN OAK RD, BOYDS, MD 20841-4222
(301) 222-7604
Mailing address
18842 BROKEN OAK RD, BOYDS, MD 20841-4222
(301) 222-7604
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R212474
MD
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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