Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 22484 | MD |
N | 2251N0400X | Physical Therapist - Neurology | 22484 | MD |
NPI | 1336747930 |
---|---|
Provider Name | Melissa Wohlberg |
First Address | Pikesville, MD 21208-2978 |
Second Address | Pikesville, MD 21208-2978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2020 |
Last Update Date | 15/10/2020 |