Individual
ANN LOUISE PEMBERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
5511 HILLFALL CT, COLUMBIA, MD 21045-2427
(410) 493-6053
(443) 718-9936
Mailing address
5511 HILLFALL CT, COLUMBIA, MD 21045-2427
(410) 493-6053
(443) 718-9936
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11264
MD
1041C0700X
Clinical Social Worker
18040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117551310
—
MD
Enumeration date
04/11/2007
Last updated
11/13/2020
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