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General NPI Number Information
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NPI Number | 1609051770
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Entity Type | Individual
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Provider Name | PHYLLIS DANITA MEYERSON
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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 | 01/08/2008
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Provider Practice Location Address
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Address Line | 10500 SUMMIT AVE
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City | KENSINGTON
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State | MD
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Zip | 20895-2422
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Country | US
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Telephone | 301-897-2320
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Fax | 301-897-2333
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Provider Business Mailing Address
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Address Line | 2101 E JEFFERSON ST
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City | ROCKVILLE
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State | MD
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Zip | 20852-4908
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Country | US
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Telephone | 301-816-7446
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Fax | 301-816-7170
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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 | 03394
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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 | 03394
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License Number State | MD
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