Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | BH000941 | MD |
NPI | 1376038976 |
---|---|
Provider Name | Gia Monique Winfield |
First Address | Baltimore, MD 21218-5797 |
Second Address | Baltimore, MD 21218-5797 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2018 |
Last Update Date | 26/06/2018 |