MEDICARE: GIA MONIQUE WINFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TR0400X	Rehabilitation Psychologist	BH000941	MD

General Provider Information

NPI Number	:	1376038976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIA MONIQUE WINFIELD

Provider Business Mailing Address
First Line	:	2118 N CHARLES ST APT 2
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-5797
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2118 N CHARLES ST APT 2
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-5797
Country	:	US
Telephone Number	:	410-361-1686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2018
Last Update Date	:	06/26/2018

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Directions to “ GIA MONIQUE WINFIELD ” Practice Location

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