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General NPI Number Information
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NPI Number | 1669170122
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Entity Type | Individual
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Provider Name | MARIA MARTA QUARLES CLC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 2028 LIBERTY RD STE 103
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City | ELDERSBURG
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State | MD
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Zip | 21784-5079
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Country | US
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Telephone | 410-598-4336
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Fax | 443-280-6441
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Provider Business Mailing Address
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Address Line | 3410 FARMSTEAD DR
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City | WESTMINSTER
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State | MD
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Zip | 21157-8329
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Country | US
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Telephone | 240-863-1334
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | ALPP-335-810
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License Number State | MD
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