Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 19185 | MD |
NPI | 1003237975 |
---|---|
Provider Name | Nicole Daskalakis |
First Address | Gaithersburg, MD 20877-4039 |
Second Address | Gaithersburg, MD 20877-4039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2013 |
Last Update Date | 19/12/2013 |