MEDICARE: MISS CAROLINE MARIE GUHDE LGSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LG50079013	DC

General Provider Information

NPI Number	:	1255643888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CAROLINE MARIE GUHDE LGSW

Provider Business Mailing Address
First Line	:	1703 E WEST HWY
Second Line	:	APT 504
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3054
Country	:	US
Telephone Number	:	202-680-9419
Fax Number	:

Provider Business Practice Location Address
First Line	:	1703 E WEST HWY
Second Line	:	APT 504
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3054
Country	:	US
Telephone Number	:	202-680-9419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	07/12/2010

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