Individual
MS. MARY J MODDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
HIGH ROAD LOWER SCHOOL, 9701 PHILADELPHIA CT., LANHAM, MD 20706
(301) 567-8494
Mailing address
4107 HAMILTON ST, HYATTSVILLE, MD 20781-1804
(301) 277-4911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01236
MD
Other
Enumeration date
04/19/2007
Last updated
03/12/2025
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