MEDICARE: THERESE HARRIGAN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	06811	MD

General Provider Information

NPI Number	:	1043469737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE HARRIGAN MSW

Provider Business Mailing Address
First Line	:	14735 MAIN ST
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3051
Country	:	US
Telephone Number	:	301-985-5960
Fax Number	:	301-699-2886

Provider Business Practice Location Address
First Line	:	14735 MAIN ST
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3051
Country	:	US
Telephone Number	:	301-985-5960
Fax Number	:	301-699-2886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2008
Last Update Date	:	09/22/2008

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