Organization
EDWARD L. MISLAK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD LEO MISLAK LCSW-C (CLINICAL SOCIAL WORKER)
(410) 893-7217
Entity
Organization
Contact information
Practice address
801 CHANCE CT, STREET, MD 21154-1648
(410) 893-7217
(410) 893-7217
Mailing address
801 CHANCE CT, STREET, MD 21154-1648
(410) 893-7217
(410) 893-7217
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
08156
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031101400
—
MD
Enumeration date
12/26/2012
Last updated
12/27/2017
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