| Doctor Name: | JANE GURGANIOUS |
| NPI Number: | 1326488487 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C |
| License Number: | 11404 |
| Business Practice Address: | 8146 Quarterfield Rd Severn, MD - 211442705 |
| Business Phone Number: | 4102630222 |
| Business Fax Number: | 4105690094 |
| Mailing Address: | 1179 Double Chestnut Ct, CHESTNUT HILL COVE |
| State: | MD |
| Postal Code: | 212262219 |
| Phone Number: | 4105699497 |
| Fax Number: | 4105690094 |
| NPI Enumeration Date: | 07/03/2013 |
| NPI Last Update Date: | 07/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 11404 |
| 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 |