Individual
VIVIAN TANTOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7452 BALTIMORE ANNAPOLIS BLVD # 200, GLEN BURNIE, MD 21061-3547
(443) 209-7100
Mailing address
7452 BALTIMORE ANNAPOLIS BLVD # 200, GLEN BURNIE, MD 21061-3547
(443) 209-7100
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
929987
TX
Other
Enumeration date
10/24/2018
Last updated
02/16/2025
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