Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 05528 | MD |
NPI | 1992994677 |
---|---|
Provider Name | Michelle Stone |
First Address | Baltimore, MD 21212-2152 |
Second Address | Baltimore, MD 21212-2152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 18/10/2007 |