Individual
ARIEL NICOLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
200 HOSPITAL DR STE 400, GLEN BURNIE, MD 21061-5884
(410) 768-5555
(888) 313-5209
Mailing address
200 HOSPITAL DR STE 400, GLEN BURNIE, MD 21061-5884
(410) 768-5555
(888) 313-5209
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10219
MD
Other
Enumeration date
04/02/2024
Last updated
04/19/2024
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