Healthcare Provider Details

I. General information

NPI: 1548041684
Provider Name (Legal Business Name): MARY-FRANCES GUMBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 ENGLAR RD STE 10
WESTMINSTER MD
21157-2927
US

IV. Provider business mailing address

250 ENGLAR RD STE 10
WESTMINSTER MD
21157-2927
US

V. Phone/Fax

Practice location:
  • Phone: 410-294-9612
  • Fax:
Mailing address:
  • Phone: 410-294-9612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number29971
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: