Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 16371 | MD |
NPI | 1003054867 |
---|---|
Provider Name | Mrs. Kristen Mary Deboy Caminiti |
First Address | Gambrills, MD 21054-2156 |
Second Address | Severna Park, MD 21146-4700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 19/10/2015 |