| Doctor Name: | MS. TACIE DEJANIKUS |
| NPI Number: | 1003968439 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.W. |
| License Number: | 12476 |
| Business Practice Address: | 1398 Lamberton Dr Silver Spring, MD - 209023414 |
| Business Phone Number: | 3017541102 |
| Business Fax Number: | 3017541690 |
| Mailing Address: | 5319 Bangor Dr, KENSINGTON |
| State: | MD |
| Postal Code: | 208951106 |
| Phone Number: | 3019331799 |
| Fax Number: | |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 12476 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |