Healthcare Provider Details
I. General information
NPI: 1982401865
Provider Name (Legal Business Name): CRISTINA ESPINOSA URDINOLA
Entity Type: Individual
Gender:
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10403 HOSPITAL DR STE G-09A
CLINTON MD
20735-3134
US
IV. Provider business mailing address
10403 HOSPITAL DR STE G-09A
CLINTON MD
20735-3134
US
V. Phone/Fax
- Phone: 202-683-4340
- Fax: 202-588-5971
- Phone: 202-683-4340
- Fax: 202-588-5971
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: