Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 26010 | MD |
NPI | 1003571274 |
---|---|
Provider Name | Kimberly Single |
First Address | Owings Mills, MD 21117-3320 |
Second Address | Baltimore, MD 21201-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2021 |
Last Update Date | 03/11/2021 |