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Individual

JOAN RUDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW-C

Contact information

Practice address
610 E DIAMOND AVE, GAITHERSBURG, MD 20877-5321
(301) 840-3200
(301) 840-1348
Mailing address
610 E DIAMOND AVE, GAITHERSBURG, MD 20877-5321
(301) 840-3200
(301) 840-1348

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11183
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0054
BLUE CROSS FEDERAL
01
212651
UNITED HEALTHCARE
MD
01
618478-02
CAREFIRST BLUE CHOICE
MD
Enumeration date
02/06/2007
Last updated
07/08/2007
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