Individual
JESSE TIRALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 STAFFORD RD, BARSTOW, MD 20610
(410) 535-5400
Mailing address
2865 HOLLAND CLIFFS RD, HUNTINGTOWN, MD 20639-8820
(443) 432-8854
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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