Provider Information for 1598187205
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MONIQUE CHURCH LCSW-C, CEAP, SAP
Sex: Female
NPI: 1598187205
Last Updated: 2014-01-29
Certification Date:
Certification Date:
Details
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NPI | 1598187205 | ||||||||
Enumeration Date | 2014-01-15 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 3924 ROLLING RD. UNIT 5B PIKESVILLE, MD 21208-2251 United States Phone: 410-521-8137 | Fax: | ||||||||
Primary Practice Address | 419 W REDWOOD ST BALTIMORE, MD 21201-1734 United States Phone: 410-328-6106 | Fax: | ||||||||
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