Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 09935 | MD |
NPI | 1003083403 |
---|---|
Provider Name | Angela Suzette Latney |
First Address | Sykesville, MD 21784-9236 |
Second Address | Owings Mills, MD 21117-4960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 14/05/2008 |