Individual
TERESA RUSK MASTANTUONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 ROSEMONT AVE, FREDERICK, MD 21702-8249
(240) 772-9200
Mailing address
2252 W GREENLEAF DR, FREDERICK, MD 21702-2625
(240) 440-2330
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
03025L
MD
Other
Enumeration date
08/22/2024
Last updated
09/06/2024
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