MEDICARE: MS. PATRICIA ANN SMITH LCSW-C

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	1041S0200X	School Social Worker	12083	MD

General Provider Information

NPI Number	:	1730359795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN SMITH LCSW-C

Provider Business Mailing Address
First Line	:	7205 RUTHERFORD RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21244-2711
Country	:	US
Telephone Number	:	443-780-1429
Fax Number	:

Provider Business Practice Location Address
First Line	:	7205 RUTHERFORD RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21244-2711
Country	:	US
Telephone Number	:	443-780-1429
Fax Number	:

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

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	03/06/2008

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