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General NPI Number Information
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NPI Number | 1902392236
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Entity Type | Individual
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Provider Name | MARY A AGUILERA-TITUS LMT, BCTMB
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 5255 LOUGHBORO RD NW
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City | WASHINGTON
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State | DC
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Zip | 20016-2696
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Country | US
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Telephone | 202-660-7775
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Fax |
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Provider Business Mailing Address
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Address Line | 13134 VALLEYWOOD DR
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City | SILVER SPRING
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State | MD
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Zip | 20906-3959
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Country | US
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Telephone | 301-946-4575
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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 | M02307
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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 | MT1255
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License Number State | DC
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