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General NPI Number Information
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NPI Number | 1154973907
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Entity Type | Individual
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Provider Name | SYLVESTER CONN LMSW
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Gender | Male
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 3112 WINDSOR AVE
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City | BALTIMORE
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State | MD
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Zip | 21216-2742
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Country | US
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Telephone | 443-762-7119
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6944
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City | BALTIMORE
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State | MD
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Zip | 21216-0944
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Country | US
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Telephone | 443-762-7119
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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 | 22740
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License Number State | MD
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