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NPI Code Detail

MEDICARE: SEAN LOFTLIN RIVERS

MEDICARE:   SEAN  LOFTLIN RIVERS
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
11041C0700XClinical Social WorkerLC50078302DC

General Provider Information

NPI Number : 1639476237
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN LOFTLIN RIVERS
Provider Business Mailing Address
First Line : 7710 JAFFREY RD
Second Line :
City : FORT WASHINGTON
State : MD
Zip : 20744-3407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7710 JAFFREY RD
Second Line :
City : FORT WASHINGTON
State : MD
Zip : 20744-3407
Country : US
Telephone Number : 240-464-6868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2011
Last Update Date : 02/28/2011

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Directions to “ SEAN LOFTLIN RIVERS ” Practice Location

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