Provider Demographics
NPI:1306604517
Name:ROBINSON, SHANEL MARANDA (CD)
Entity type:Individual
Prefix:MS
First Name:SHANEL
Middle Name:MARANDA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 N MARLYN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-1306
Mailing Address - Country:US
Mailing Address - Phone:443-525-4352
Mailing Address - Fax:
Practice Address - Street 1:1023 N MARLYN AVE
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-1306
Practice Address - Country:US
Practice Address - Phone:443-525-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula