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General NPI Number Information
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NPI Number | 1346375664
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Entity Type | Organization
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Legal Business Name | TRISH CARUANA PA
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6611 MARIETTA AVE
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City | BALTIMORE
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State | MD
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Zip | 21214-1112
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Country | US
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Telephone | 410-687-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 6611 MARIETTA AVE
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City | BALTIMORE
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State | MD
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Zip | 21214-1112
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Country | US
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Telephone | 410-687-6060
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA ANN CARUANA
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Credential | L.C.S.W.-C
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Telephone | 410-687-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 08427
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License Number State | MD
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