Individual
CHARLES BRILLIANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
3900 LOCH RAVEN BLVD, BALTIMORE, MD 21218-2108
(410) 605-7521
(410) 605-7589
Mailing address
6201 GATEPOST WAY, ELKRIDGE, MD 21075-6021
(410) 605-7521
(410) 605-7589
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
07321
MD
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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