Healthcare Provider Details

I. General information

NPI: 1407254097
Provider Name (Legal Business Name): ANNA XOCHITL GUZMAN MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2014
Last Update Date: 05/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 ANNAPOLIS RD STE B2
LANHAM MD
20706-2062
US

IV. Provider business mailing address

9500 ANNAPOLIS RD STE B2
LANHAM MD
20706-2062
US

V. Phone/Fax

Practice location:
  • Phone: 301-850-1148
  • Fax: 866-250-3233
Mailing address:
  • Phone: 301-850-1148
  • Fax: 866-250-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20523
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: