Individual
MS. KATHERINE BLAIR WISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCW-C
Contact information
Practice address
6123 MONTROSE RD, ROCKVILLE, MD 20852
(301) 881-3700
(301) 468-1862
Mailing address
6123 MONTROSE RD, ROCKVILLE, MD 20852-4860
(301) 838-4200
(301) 309-2596
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12093
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236676
KAISER
MD
05
—
403337000
—
MD
01
—
589530000
MAGELLAN
MD
01
—
622642 01
BCBS OF MD
MD
01
—
7134551
AETNA
MD
01
—
A2840130
BCBS OF DC
DC
Enumeration date
08/13/2006
Last updated
04/24/2013
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