Individual
JACQUELINE KOUBEK LANIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
1419 FOREST DR STE 104, ANNAPOLIS, MD 21403-1453
(410) 562-8177
Mailing address
20 BURNHAM WOOD CT, ANNAPOLIS, MD 21403-1644
(410) 562-8177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
07375
MD
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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