Healthcare Provider Details

I. General information

NPI: 1295472405
Provider Name (Legal Business Name): PRISCILLA LOUISE HUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

IV. Provider business mailing address

1404 GREENDALE CT
ARNOLD MD
21012-2074
US

V. Phone/Fax

Practice location:
  • Phone: 617-297-7998
  • Fax:
Mailing address:
  • Phone: 301-542-5868
  • 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: