Healthcare Provider Details

I. General information

NPI: 1851884753
Provider Name (Legal Business Name): RYANN PLOTKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 CROMWELL BRG RD
BALTIMORE MD
21286-3318
US

IV. Provider business mailing address

1026 CROMWELL BRG RD
BALTIMORE MD
21286-3318
US

V. Phone/Fax

Practice location:
  • Phone: 410-583-1515
  • Fax:
Mailing address:
  • Phone: 410-583-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: