Individual
MS. JENNIFER DETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
71 FLINT DR, NORTH EAST, MD 21901-3746
(443) 945-8754
Mailing address
71 FLINT DR, NORTH EAST, MD 21901-3746
(443) 945-8754
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
24536
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24536
MARYLAND BOARD OF SOCIAL WORK EXAMINERS
MD
Enumeration date
02/02/2016
Last updated
02/02/2023
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