Individual
BRENDA CARLEEN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 SEABURY RD, BALTIMORE, MD 21225-1244
(410) 984-3625
Mailing address
12607 WALLACE LN, UPPER MARLBORO, MD 20772-7978
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16863
MD
Other
Enumeration date
05/22/2019
Last updated
06/11/2019
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