Healthcare Provider Details

I. General information

NPI: 1851204408
Provider Name (Legal Business Name): QUENTIN WASHINGTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 LANGLEY RD N
GLEN BURNIE MD
21060-6531
US

IV. Provider business mailing address

122 LANGLEY RD N
GLEN BURNIE MD
21060-6531
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-6785
  • Fax:
Mailing address:
  • Phone: 410-222-6785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33685
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: