MEDICARE: MRS. MARY-BETH SMITH MSW

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	1041C0700X	Clinical Social Worker	MD2798	MD

General Provider Information

NPI Number	:	1467459594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY-BETH SMITH MSW

Provider Business Mailing Address
First Line	:	2 HAMILL RD
Second Line	:	SUITE 316
City	:	BALTIMORE
State	:	MD
Zip	:	21210-1806
Country	:	US
Telephone Number	:	410-435-8822
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 HAMILL RD
Second Line	:	SUITE 316
City	:	BALTIMORE
State	:	MD
Zip	:	21210-1806
Country	:	US
Telephone Number	:	410-435-8822
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/08/2007

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