Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | LC1778 | MD |
NPI | 1003921248 |
---|---|
Provider Name | Jadranka Milovanovic |
First Address | Columbia, MD 21044-6239 |
Second Address | Catonsville, MD 21228-4134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 17/09/2009 |