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General NPI Number Information
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NPI Number | 1356837991
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Entity Type | Individual
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Provider Name | CAROLINE GOMES
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Gender | Female
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 07/06/2018
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Provider Practice Location Address
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Address Line | 787 OELLA AVE
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4727
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Country | US
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Telephone | 443-720-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 6409 WINSTON DR
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City | BETHESDA
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State | MD
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Zip | 20817-5821
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Country | US
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Telephone | 240-418-0421
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 23614
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License Number State | MD
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