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General NPI Number Information
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NPI Number | 1932830502
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Entity Type | Individual
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Provider Name | JOSE FRANCISCO BONANGELINO LMSW
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 903 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-4725
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Country | US
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Telephone | 301-941-7042
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Fax |
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Provider Business Mailing Address
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Address Line | 7620 CARTERET RD # 25
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City | BETHESDA
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State | MD
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Zip | 20817-2021
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Country | US
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Telephone | 301-767-5773
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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 | 24656
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License Number State | MD
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