Healthcare Provider Details

I. General information

NPI: 1639952062
Provider Name (Legal Business Name): RICKIA T TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 08/17/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7896 GEORGIA AVE
SILVER SPRING MD
20910-4859
US

IV. Provider business mailing address

7896 GEORGIA AVE # 200
SILVER SPRING MD
20910-4859
US

V. Phone/Fax

Practice location:
  • Phone: 202-569-3255
  • Fax:
Mailing address:
  • Phone: 202-569-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: