Healthcare Provider Details

I. General information

NPI: 1063418770
Provider Name (Legal Business Name): BRITT HUNTLY RATHBONE MSSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5942 HUBBARD DR
ROCKVILLE MD
20852-4824
US

IV. Provider business mailing address

5942 HUBBARD DR
ROCKVILLE MD
20852-4824
US

V. Phone/Fax

Practice location:
  • Phone: 301-230-9490
  • Fax: 301-230-9865
Mailing address:
  • Phone: 301-230-9490
  • Fax: 301-230-9865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number05955
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: