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Individual

MS. CAROL ANN LIBONATI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
810 LIGHT ST., SUITE 103, BALTIMORE, MD 21230
(410) 908-2099
(410) 243-2507
Mailing address
3801 JUNIPER RD, BALTIMORE, MD 21218-1828
(410) 243-8306
(410) 243-2507

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R039456
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002505
VALUE OPTIONS
MD
01
1049727
CIGNA
MD
01
167836
COMPSYCH
MD
01
23382
EMPLOYEE HEALTH PLAN
MD
01
364943
MAMSI
MD
01
9079442
MULTIPLAN
MD
01
G4640001
CAREFIRST FEDERAL EMPLOYE
MD
01
IP 276313
MAGELLAN
MD
01
PQ02CA
CAREFIRST BLUE CROSS BLUE
MD
01
PVPB101825
AMERICAN PSYCH SYSTEMS
MH
Enumeration date
04/19/2007
Last updated
07/08/2007
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