Organization
CONSTANCE W. PULLEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCE W. PULLEN LCSW-C (OWNER)
(410) 822-6501
Entity
Organization
Contact information
Practice address
25800 AVONIA LN, ROYAL OAK, MD 21662-1417
(410) 822-6501
Mailing address
25800 AVONIA LN, ROYAL OAK, MD 21662-1417
(410) 822-6501
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160241100
—
MD
Enumeration date
02/08/2022
Last updated
02/08/2022
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