Individual provider · Type 1 NPI
Wanda Pulliam
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Baltimore, MD
Practice location
843 N Augusta Ave
Baltimore, MD 21229-1823
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Another provider at this address
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About NPI 1609523885
Wanda Pulliam's National Provider Identifier is 1609523885, issued on Mar 7, 2022. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Baltimore, MD. The record was last updated on Mar 7, 2022.