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General NPI Number Information
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NPI Number | 1376996314
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Entity Type | Individual
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Provider Name | ELIZABETH YOUNG QUESENBERRY LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 815 RITCHIE HWY STE 108
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City | SEVERNA PARK
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State | MD
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Zip | 21146-4192
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Country | US
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Telephone | 804-363-0153
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Fax |
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Provider Business Mailing Address
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Address Line | 6745 OLD WATERLOO RD APT 224
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City | ELKRIDGE
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State | MD
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Zip | 21075-7121
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Country | US
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Telephone | 804-363-0153
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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 |
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License Number State |
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