Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 19526 | MD |
NPI | 1003247032 |
---|---|
Provider Name | Laura Kulick |
First Address | Baltimore, MD 21211-2002 |
Second Address | Baltimore, MD 21201-1023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2013 |
Last Update Date | 06/10/2014 |