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General NPI Number Information
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NPI Number | 1588770523
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Entity Type | Individual
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Provider Name | MIRIAM M LOVE L.C.S.W-C
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7120 MINSTREL WAY SUITE 203
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City | COLUMBIA
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State | MD
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Zip | 21045
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Country | US
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Telephone | 443-325-1151
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Fax | 410-381-4711
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Provider Business Mailing Address
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Address Line | 11041 DORSCH FARM RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-6267
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Country | US
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Telephone | 410-992-1469
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Fax | 441-038-1471
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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 | 10061
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904001503
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License Number State | VA
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