MEDICARE: MRS. MARTINE JEAN-BAPTISTE

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	16411	MD

General Provider Information

NPI Number	:	1851694152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTINE JEAN-BAPTISTE

Provider Business Mailing Address
First Line	:	7205 RUTHERFORD RD
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-2711
Country	:	US
Telephone Number	:	410-917-8889
Fax Number	:

Provider Business Practice Location Address
First Line	:	7205 RUTHERFORD RD
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-2711
Country	:	US
Telephone Number	:	410-917-8889
Fax Number	:

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

Provider Enumeration Date	:	12/09/2010
Last Update Date	:	12/09/2010

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