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Individual

GAYLE BROMBERG

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LCSW-C

Contact information

Practice address
170 THOMAS JOHNSON DR, STE 210, FREDERICK, MD 21702-4354
(301) 695-8390
(301) 694-7906
Mailing address
170 THOMAS JOHNSON DR, STE 210, FREDERICK, MD 21702-4354
(301) 695-8390
(301) 694-7906

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
04118
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
239102
MAMSI
MD
Enumeration date
06/02/2005
Last updated
07/08/2007
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