Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 12663 | MD |
NPI | 1003195975 |
---|---|
Provider Name | Ms. Angela Faith Noppenberger |
First Address | Baltimore, MD 21211-1595 |
Second Address | Baltimore, MD 21211-1595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2011 |
Last Update Date | 30/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
376751500 | (05) | MD |
S732 | (02) | MD |