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General NPI Number Information
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NPI Number | 1295134005
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Entity Type | Organization
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Legal Business Name | PRINCE GEORGES COUNTY HEALTH DEPT.
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 301 HAMPTON PARK BLVD
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City | CAPITOL HGTS
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State | MD
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Zip | 20743-3822
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Country | US
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Telephone | 301-324-2838
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Fax |
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Provider Business Mailing Address
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Address Line | 301 HAMPTON PARK BLVD.
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City | CAPITAL HGTS.
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State | MD
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Zip | 20743
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Country | US
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Telephone | 301-324-2838
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. BARBARA MCNAIR
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Credential | LCSW-C
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Telephone | 301-324-2838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 11921
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License Number State | MD
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