Healthcare Provider Details

I. General information

NPI: 1710492921
Provider Name (Legal Business Name): PRINCESS R ASLAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7070 SAMUEL MORSE DR
COLUMBIA MD
21046-3424
US

IV. Provider business mailing address

7070 SAMUEL MORSE DR
COLUMBIA MD
21046-3424
US

V. Phone/Fax

Practice location:
  • Phone: 410-309-4710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-88105
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: