Healthcare Provider Details

I. General information

NPI: 1760397608
Provider Name (Legal Business Name): TRISTA E WARE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9199 REISTERSTOWN RD STE 211C
OWINGS MILLS MD
21117-4501
US

IV. Provider business mailing address

20005 CANEBRAKE CT
GAITHERSBURG MD
20886-4943
US

V. Phone/Fax

Practice location:
  • Phone: 443-729-0828
  • Fax:
Mailing address:
  • Phone: 443-729-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: