Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 15843 | MD |
NPI | 1003034158 |
---|---|
Provider Name | Ms. Safi Khadija Lynch |
First Address | Cheltenham, MD 20623-0244 |
Second Address | Upper Marlboro, MD 20774-4783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 17/11/2012 |