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Individual

MRS. SHARON JOHNSON WATERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSC-AD

Contact information

Practice address
3680 WARWICK RD, EAST NEW MARKET, MD 21631-1420
(410) 943-8108
Mailing address
3680 WARWICK RD, EAST NEW MARKET, MD 21631-1420
(410) 943-8108

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC1038
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
631501100
MD
Enumeration date
12/13/2011
Last updated
12/13/2011
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