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NPI Code Detail

MEDICARE: BRITANY DIEVENDORF

MEDICARE: BRITANY DIEVENDORF
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
1104100000XSocial Worker33909MD

General Provider Information

NPI Number : 1275370777
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITANY DIEVENDORF
Provider Business Mailing Address
First Line : 20410 OBSERVATION DR STE 212
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-4068
Country : US
Telephone Number : 240-296-6035
Fax Number :
Provider Business Practice Location Address
First Line : 20410 OBSERVATION DR STE 212
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-4068
Country : US
Telephone Number : 240-296-6035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2024
Last Update Date : 03/05/2026

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1124663794 — DEBORAH ANN SWANSTROM LCSW-C
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Directions to “ BRITANY DIEVENDORF ” Practice Location

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