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General NPI Number Information
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NPI Number | 1790067221
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Entity Type | Individual
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Provider Name | JOANNA ROSE KATHERMAN LGSW
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Gender | Female
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Dates
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Enumeration Date | 09/11/2011
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Last Update Date | 09/11/2011
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Provider Practice Location Address
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Address Line | 606 SUNNYSIDE AVE
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City | DENTON
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State | MD
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Zip | 21629-1341
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Country | US
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Telephone | 410-479-3800
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Fax | 410-479-0052
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Provider Business Mailing Address
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Address Line | 322 N LAKE RD
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City | STEVENSVILLE
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State | MD
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Zip | 21666-3444
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Country | US
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Telephone | 570-419-0892
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 16441
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License Number State | MD
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