Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | J1-0014236 | DE |
NPI | 1588271431 |
---|---|
Provider Name | Alison Herrera |
First Address | Baltimore, MD 21287-0010 |
Second Address | Baltimore, MD 21201-1794 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2020 |
Last Update Date | 24/09/2020 |