Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 07401 | MD |
NPI | 1003077827 |
---|---|
Provider Name | Susan Marie Plakitsis |
First Address | Hunt Valley, MD 21031-9999 |
Second Address | Hunt Valley, MD 21031-8611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 14/06/2017 |