Individual
MRS. PENNY COZETTE MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2707 KILDAIRE DR, BALTIMORE, MD 21234-7634
(410) 624-6395
Mailing address
2707 KILDAIRE DR, BALTIMORE, MD 21234-7634
(410) 624-6395
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
27892
MD
1041C0700X
Clinical Social Worker
27892
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27892
CIGNA, AETNA
MD
Enumeration date
12/16/2022
Last updated
12/16/2022
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