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General NPI Number Information
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NPI Number | 1346599602
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Entity Type | Individual
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Provider Name | MRS. EDA GRIFFITHS-BASCOME
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Gender | Female
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Dates
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Enumeration Date | 09/02/2012
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Last Update Date | 09/02/2012
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Provider Practice Location Address
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Address Line | 401 E EAGER ST
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City | BALTIMORE
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State | MD
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Zip | 21202-4214
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Country | US
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Telephone | 410-281-7801
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Fax |
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Provider Business Mailing Address
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Address Line | 9313 NEW HAMPSHIRE AVE
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City | SILVER SPRING
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State | MD
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Zip | 20903-2315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R108951
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License Number State | MD
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