Healthcare Provider Details

I. General information

NPI: 1285543207
Provider Name (Legal Business Name): COLLEEN MICHELE DEVANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SUNSET DR
GLEN BURNIE MD
21060-6634
US

IV. Provider business mailing address

103 SUNSET DR
GLEN BURNIE MD
21060-6634
US

V. Phone/Fax

Practice location:
  • Phone: 301-785-3147
  • Fax:
Mailing address:
  • Phone: 301-785-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: