Individual
PATRICE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
9755 MILL CENTRE DR APT 529, OWINGS MILLS, MD 21117-3981
(443) 804-6345
Mailing address
9755 MILL CENTRE DR APT 529, OWINGS MILLS, MD 21117-3981
(443) 804-6345
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-3371600
IRS
MD
Enumeration date
12/02/2019
Last updated
12/02/2019
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