Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 18037 | MD |
NPI | 1043775901 |
---|---|
Provider Name | Ms. Maria Laura Soto |
First Address | Greenbelt, MD 20770-3041 |
Second Address | Laurel, MD 20707-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2019 |
Last Update Date | 05/02/2019 |