Individual
MRS. AMY LYNN EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.-C.
Contact information
Practice address
507 W CHESAPEAKE AVE, SUITE 509, TOWSON, MD 21204-4345
(443) 519-5752
Mailing address
123 HERITAGE LN, SYKESVILLE, MD 21784-9418
(410) 971-1371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09465
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405288900
—
MD
05
—
808601000
—
MD
Enumeration date
11/20/2006
Last updated
01/08/2014
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