Individual
DESIREE LUERENE ISRAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
2000 GREENMOUNT AVE STE 101, BALTIMORE, MD 21218
(410) 513-9611
Mailing address
2000 GREENMOUNT AVE STE 101, BALTIMORE, MD 21218-6164
(410) 513-9611
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17259
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38-3876389
—
MD
Enumeration date
11/06/2018
Last updated
08/25/2020
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