Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 15185 | MD |
NPI | 1003134362 |
---|---|
Provider Name | Jade Lin Bean |
First Address | Cumberland, MD 21502-6393 |
Second Address | Cumberland, MD 21502-6393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2010 |
Last Update Date | 12/05/2010 |