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General NPI Number Information
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NPI Number | 1790114379
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Entity Type | Organization
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Legal Business Name | NAVA MARYLAND, LLC
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 8880 MCGAW RD SUITE B
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City | COLUMBIA
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State | MD
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Zip | 21045
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Country | US
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Telephone | 800-762-6282
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Fax |
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Provider Business Mailing Address
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Address Line | 9755 PATUXENT WOODS DRIVE SUITE 100
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City | COLUMBIA
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State | MD
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Zip | 21046
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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 | E.V.P.
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Name | JENNIFER REALO
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Credential |
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Telephone | 410-910-2827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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