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General NPI Number Information
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NPI Number | 1952428633
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Entity Type | Individual
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Provider Name | MELANIE JEANEAN HERRERA LSWA
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6401 YORK RD
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City | BALTIMORE
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State | MD
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Zip | 21212-2152
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Country | US
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Telephone | 443-429-4510
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Fax |
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Provider Business Mailing Address
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Address Line | 6503 WINDSOR MILL RD
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City | GWYNN OAK
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State | MD
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Zip | 21207-5380
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Country | US
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Telephone | 443-429-4510
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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 | A05098
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License Number State | MD
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