Individual
STEPHANIE VANDERVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CACAD
Contact information
Practice address
1501 W SARATOGA ST, BALTIMORE, MD 21223-1749
(410) 383-3129
Mailing address
1501 W SARATOGA ST, BALTIMORE, MD 21223-1749
(410) 383-3129
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC1683
MD
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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