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General NPI Number Information
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NPI Number | 1972609634
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Entity Type | Individual
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Provider Name | WENDY R KAUFMAN LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 616 CHARLES ST SUITE 106
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City | LA PLATA
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State | MD
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Zip | 20646-5937
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Country | US
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Telephone | 301-753-8306
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Fax | 301-753-4991
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Provider Business Mailing Address
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Address Line | PO BOX 955
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City | LA PLATA
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State | MD
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Zip | 20646-0955
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Country | US
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Telephone | 301-753-8306
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Fax | 301-754-4991
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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 | MD 09564
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License Number State | MD
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