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General NPI Number Information
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NPI Number | 1891452751
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Entity Type | Individual
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Provider Name | LATANYA VETA BROWN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2021
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Last Update Date | 11/25/2021
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Provider Practice Location Address
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Address Line | 1001 TWIN ARCH RD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-4138
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Country | US
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Telephone | 301-829-1499
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Fax |
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Provider Business Mailing Address
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Address Line | 10205 WASHINGTONIAN BLVD APT 543
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City | GAITHERSBURG
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State | MD
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Zip | 20878-8322
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Country | US
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Telephone | 301-332-0165
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | T25645
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License Number State | MD
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