Healthcare Provider Details

I. General information

NPI: 1417625955
Provider Name (Legal Business Name): ADRIANA ESPINOZA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 CORK RD
GLEN BURNIE MD
21060-8262
US

IV. Provider business mailing address

374 CORK RD
GLEN BURNIE MD
21060-8262
US

V. Phone/Fax

Practice location:
  • Phone: 732-948-6975
  • Fax:
Mailing address:
  • Phone: 732-948-6975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24341
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: