Healthcare Provider Details

I. General information

NPI: 1336277409
Provider Name (Legal Business Name): TRINA SHERELL TOWNSEND BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11559 SOMERSET AVE
PRINCESS ANNE MD
21853
US

IV. Provider business mailing address

2336 GODDARD PARKWAY
SALISBURY MD
21801
US

V. Phone/Fax

Practice location:
  • Phone: 410-651-4200
  • Fax: 410-651-4290
Mailing address:
  • Phone: 410-334-6961
  • Fax: 410-334-6960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: