Doctor Name: | MOLLIE WIDDOWSON |
NPI Number: | 1548618598 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 19302 |
Business Practice Address: | 11670 Old National Pike 103 New Market, MD - 217746123 |
Business Phone Number: | 3018652226 |
Business Fax Number: | 3018656720 |
Mailing Address: | 11670 Old National Pike, 103 NEW MARKET |
State: | MD |
Postal Code: | 217746123 |
Phone Number: | 3018652226 |
Fax Number: | 3018656720 |
NPI Enumeration Date: | 06/01/2016 |
NPI Last Update Date: | 06/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 19302 |
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 |