Individual
TATIANA PEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
702 RUSSELL AVE STE 100, GAITHERSBURG, MD 20877-2605
(301) 330-0006
(301) 330-0444
Mailing address
702 RUSSELL AVE STE 100, GAITHERSBURG, MD 20877-2605
(301) 330-0006
(301) 330-0444
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
26663
MD
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW26663
STATE BOARD OF SOCIAL WORK EXAMINERS
MD
Enumeration date
12/13/2017
Last updated
04/07/2021
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