| Doctor Name: | ANN LOUISE PEMBERTON |
| NPI Number: | 1003039587 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C |
| License Number: | 18040 |
| Business Practice Address: | 10451 Twin Rivers Rd Suite 100 Columbia, MD - 210442388 |
| Business Phone Number: | 4109973557 |
| Business Fax Number: | 4109641791 |
| Mailing Address: | 4623 Falls Rd, BALTIMORE |
| State: | MD |
| Postal Code: | 212094914 |
| Phone Number: | 4103661980 |
| Fax Number: | 4103668530 |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 06/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 18040 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |