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General NPI Number Information
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NPI Number | 1043842693
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Entity Type | Individual
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Provider Name | CAROLINE KINNA LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 5301 BUCKEYSTOWN PIKE STE 170
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City | FREDERICK
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State | MD
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Zip | 21704-8380
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Country | US
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Telephone | 301-733-0330
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Fax |
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Provider Business Mailing Address
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Address Line | 13121 BROOK LANE
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City | HAGERSTOWN
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State | MD
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Zip | 21742
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Country | US
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Telephone | 301-733-0331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | MD
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