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General NPI Number Information
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NPI Number | 1609698554
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Entity Type | Individual
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Provider Name | TAWANA MONROE MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 9560 MARLBORO PIKE STE 101
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-3770
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Country | US
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Telephone | 240-709-6213
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Fax |
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Provider Business Mailing Address
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Address Line | 5180 CLACTON AVE
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City | SUITLAND
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State | MD
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Zip | 20746-3828
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Country | US
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Telephone | 240-550-5807
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | R03313
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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