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General NPI Number Information
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NPI Number | 1356518161
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Entity Type | Organization
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Legal Business Name | CHAMPALOUX AND ASSOCIATES
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 14300 GALLANT FOX LN #109
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City | BOWIE
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State | MD
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Zip | 20715-4003
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Country | US
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Telephone | 301-262-8522
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Fax | 301-299-4731
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Provider Business Mailing Address
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Address Line | 14300 GALLANT FOX LN #109
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City | BOWIE
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State | MD
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Zip | 20715-4003
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Country | US
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Telephone | 301-262-8522
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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 | MRS. BARBARA RITA CHAMPALOUX
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Credential | L.C.S. W. -C.
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Telephone | 301-299-4426
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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 | 02857
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License Number State | MD
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