Individual
PATRICE DUPERVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
30007 BUSINESS CENTER DR, CHARLOTTE HALL, MD 20622-3101
(301) 997-1300
Mailing address
21770 FDR BLVD, LEXINGTON PARK, MD 20653-1558
(301) 863-6661
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
18164
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18164
MARYLAND STATE LICENSE
MD
Enumeration date
05/17/2013
Last updated
05/17/2013
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