Healthcare Provider Details

I. General information

NPI: 1174436349
Provider Name (Legal Business Name): ADIA CHAMBERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5924 BRYN MAWR RD
COLLEGE PARK MD
20740-3044
US

IV. Provider business mailing address

5924 BRYN MAWR RD
COLLEGE PARK MD
20740-3044
US

V. Phone/Fax

Practice location:
  • Phone: 240-548-8563
  • Fax:
Mailing address:
  • Phone: 240-548-8563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberR02984
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: