Provider Demographics
NPI:1215382346
Name:LAWAL, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LAWAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 QUEENS CHAPEL RD
Mailing Address - Street 2:APT. 217
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1181
Mailing Address - Country:US
Mailing Address - Phone:202-394-9201
Mailing Address - Fax:
Practice Address - Street 1:3001 QUEENS CHAPEL RD
Practice Address - Street 2:APT. 217
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1181
Practice Address - Country:US
Practice Address - Phone:202-394-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11338374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide