Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 02903 | MD |
N | 1041C0700X | Clinical Social Worker | LC300309 | DC |
NPI | 1003086414 |
---|---|
Provider Name | Ms. Annette Jolles |
First Address | Bethesda, MD 20817-6554 |
Second Address | Bethesda, MD 20817-6554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2008 |
Last Update Date | 03/03/2008 |