Provider Demographics
NPI:1093231375
Name:BALTIMORE, BRENDA ANN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:ANN
Last Name:BALTIMORE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 TERRACO TER
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20623-1223
Mailing Address - Country:US
Mailing Address - Phone:301-357-5934
Mailing Address - Fax:
Practice Address - Street 1:10501 TERRACO TER
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:MD
Practice Address - Zip Code:20623-1223
Practice Address - Country:US
Practice Address - Phone:301-357-5934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist