Healthcare Provider Details

I. General information

NPI: 1457163511
Provider Name (Legal Business Name): MS. SIMONE C MAU-SLONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11140 ROCKVILLE PIKE STE 100
ROCKVILLE MD
20852-3149
US

IV. Provider business mailing address

7004 LAMP POST LN
ALEXANDRIA VA
22306-1325
US

V. Phone/Fax

Practice location:
  • Phone: 240-575-6210
  • Fax: 240-877-0511
Mailing address:
  • Phone: 571-303-8502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: