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NPI Code Detail

MEDICARE: MS. NOLA GEORGE

MEDICARE: MS. NOLA GEORGE
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
1222Q00000XDevelopmental Therapist
2103K00000XBehavior AnalystMD

General Provider Information

NPI Number : 1598237679
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NOLA GEORGE
Provider Business Mailing Address
First Line : 316 S DUNCAN ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21231-2737
Country : US
Telephone Number : 240-491-1376
Fax Number :
Provider Business Practice Location Address
First Line : 7375 EXECUTIVE PL STE 203
Second Line :
City : LANHAM
State : MD
Zip : 20706-6236
Country : US
Telephone Number : 301-970-9678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2018
Last Update Date : 04/07/2023

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Directions to “ MS. NOLA GEORGE ” Practice Location

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