Healthcare Provider Details

I. General information

NPI: 1073347662
Provider Name (Legal Business Name): RAQUEL MARIA ZUNIGA LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5557 BALTIMORE AVE STE 500-946
HYATTSVILLE MD
20781-1922
US

IV. Provider business mailing address

5557 BALTIMORE AVE STE 500-946
HYATTSVILLE MD
20781-1922
US

V. Phone/Fax

Practice location:
  • Phone: 443-529-9028
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23052
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: