Individual
MS. WANDA WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1055 TAYLOR AVE STE 203, TOWSON, MD 21286-8333
(443) 310-3042
Mailing address
6220 TRAMORE RD, BALTIMORE, MD 21214-1534
(410) 274-3724
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
25307
MD
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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