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Organization

D.A. WYNNE & ASSOCIATES,INC.

Active
Parent organization
D.A. WYNNE & ASSOCIATES, INC.
Other names
The Silver Spring Outpatient Program
Organization subpart
Yes

Provider details

NPI number
Legal business name
D.A. WYNNE & ASSOCIATES, INC.
Authorized official
ELIZABETH C KRUEGER LCSW-C, MPH (CLINICAL DIRECTOR)
(301) 439-6700
Entity
Organization

Contact information

Practice address
11900 PARKLAWN DR STE 120, ROCKVILLE, MD 20852-2668
(301) 468-5663
Mailing address
11900 PARKLAWN DR STE 120, ROCKVILLE, MD 20852-2668
(301) 468-5663

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457474017
MD
05
1700363223
MD
Enumeration date
09/10/2018
Last updated
09/10/2018
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