Individual
MRS. ERICA LOLLER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
819 RITCHIE HWY STE 1020, SEVERNA PARK, MD 21146-4193
(410) 431-5111
(410) 431-5112
Mailing address
819 RITCHIE HWY STE 1020, SEVERNA PARK, MD 21146-4193
(410) 431-5111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10795
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999005400
—
MD
Enumeration date
09/27/2017
Last updated
09/08/2018
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