Individual
ELIZABETH ROSE BLACK MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 N SUMMIT AVE, GAITHERSBURG, MD 20877-2921
(240) 740-4900
Mailing address
620 E DIAMOND AVE STE H, GAITHERSBURG, MD 20877-5328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
26128
MD
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
01/09/2017
Last updated
09/01/2020
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