Provider Information for 1386193282
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Mrs. NICOLE WHITE-SAMUELS LGSW
Sex: Female
NPI: 1386193282
Last Updated: 2016-10-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1386193282 | ||||||||
| Enumeration Date | 2016-10-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 705 WALNUT GROVE RD BALTIMORE, MD 21221-6061 United States Phone: 410-365-3431 | Fax: | ||||||||
| Primary Practice Address | 705 WALNUT GROVE RD BALTIMORE, MD 21221-6061 United States Phone: 410-365-3431 | Fax: | ||||||||
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