Individual
JENNIFER VINE DUTROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1447 YORK RD STE 506, LUTHERVILLE, MD 21093-6022
(410) 825-2282
Mailing address
4312 GREEN GLADE RD, PHOENIX, MD 21131-1704
(410) 215-9758
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
05358
MD
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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