Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | G11786 | MD |
NPI | 1003036542 |
---|---|
Provider Name | Ms. Robin Nicole Clay |
First Address | Columbia, MD 21045-4146 |
Second Address | Aberdeen, MD 21001-2428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |