Individual
MS. WANDA INEZ DOMINIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1918 DRUID HILL AVE, BALTIMORE, MD 21217-3502
(443) 872-3533
(443) 872-3533
Mailing address
1918 DRUID HILL AVE, BALTIMORE, MD 21217-3502
(443) 872-3533
(443) 872-3533
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP40543
MD
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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