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General NPI Number Information
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NPI Number | 1528482403
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Entity Type | Organization
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Legal Business Name | THE MARTIN POLLAK PROJECT INC.
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 3701 EASTERN AVE 21224
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City | BALTIMORE
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State | MD
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Zip | 21224-4208
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Country | US
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Telephone | 443-520-7699
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Fax | 410-605-9678
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Provider Business Mailing Address
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Address Line | 3701 EASTERN AVE 21224
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City | BALTIMORE
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State | MD
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Zip | 21224-4208
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Country | US
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Telephone | 443-520-7699
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Fax | 410-605-9678
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Authorized Official
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Title or Position | CEO
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Name | MR. RICHARD L. NORMAN
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Credential | LCSW-C
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Telephone | 410-685-2525
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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 | 02418
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License Number State | MD
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