Healthcare Provider Details

I. General information

NPI: 1538050489
Provider Name (Legal Business Name): CIERRA JANAE CULP-MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 E WASHINGTON ST
ELIZABETHTOWN PA
17022-2332
US

IV. Provider business mailing address

9377 PEP RALLY LN
WALDORF MD
20603-3845
US

V. Phone/Fax

Practice location:
  • Phone: 717-256-3942
  • Fax:
Mailing address:
  • Phone: 301-653-5441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number19648
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: