Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCA301 | MD |
N | 1041C0700X | Clinical Social Worker | 09776 | MD |
NPI | 1003031832 |
---|---|
Provider Name | Mary Viggiani |
First Address | Owings Mills, MD 21117-2405 |
Second Address | Cockeysville, MD 21030-3314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |