| Joanna Durham Llc | |
|
3355 St Johns Lane Suite F Ellicott City MD 21043 | |
| (410) 456-7022 | |
| (410) 465-4822 |
| Full Name | Joanna Durham Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3355 St Johns Lane, Ellicott City, Maryland |
| Authorized Official Name and Position | Joanna Ruth Durham (OWNER) |
| Authorized Official Contact | 4104567022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joanna Durham Llc Po Box 755 Ellicott City MD 21041 Ph: (410) 456-7022 | Joanna Durham Llc 3355 St Johns Lane Suite F Ellicott City MD 21043 Ph: (410) 456-7022 |
| NPI Number | 1033251202 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033251202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 09934 (Maryland) | Primary |
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