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Individual

MRS. MARY ANTOINETTE MALANOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW C

Contact information

Practice address
336 SOUTH MAIN STREET STE 1 A, BEL AIR, MD 21014
(410) 893-0995
(410) 339-7169
Mailing address
6300 MAGDOLENA RD, BALTO, MD 21237
(410) 866-2998

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
07393
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
078344
VALUE OPTIONS
01
226037
COM PSYCH
01
58050002
CARE FIRST BCBS
MD
01
6248839
UNITED BEHAVIORAL HEALTH
Enumeration date
12/18/2006
Last updated
07/08/2007
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