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General NPI Number Information
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NPI Number | 1437334562
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Entity Type | Individual
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Provider Name | RANESA L. BOLANDER LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 138 SHELLCOVE RD
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City | PASADENA
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State | MD
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Zip | 21122-3045
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Country | US
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Telephone | 443-889-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 3635 OLD COURT RD SUITE 208
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City | BALTIMORE
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State | MD
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Zip | 21208-3915
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Country | US
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Telephone | 410-602-0102
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Fax | 410-602-8492
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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 | 12312
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License Number State | MD
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