Provider Demographics
NPI:1982401410
Name:MASOM, NAILA
Entity type:Individual
Prefix:
First Name:NAILA
Middle Name:
Last Name:MASOM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 FOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3029
Mailing Address - Country:US
Mailing Address - Phone:408-499-1233
Mailing Address - Fax:
Practice Address - Street 1:2048 FOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3029
Practice Address - Country:US
Practice Address - Phone:408-499-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health