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NPI 1780831941

NPI 1780831941 : JOANNE JOHNSON : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1780831941
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    Entity Type          |    Individual 
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    Provider Name        |    JOANNE JOHNSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/19/2008
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    Last Update Date     |    08/19/2008
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Provider Practice Location Address
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    Address Line         |    1777 REISTERSTOWN RD SUITE199
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21208-1306
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    Country              |    US
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    Telephone            |    410-764-9400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1777 REISTERSTOWN ROAD SUITE199
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21208
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    Country              |    US
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    Telephone            |    
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    12410
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    License Number State |    MD
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