Provider Demographics
NPI:1003086414
Name:JOLLES, ANNETTE (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:
Last Name:JOLLES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 WESTLAKE TERRACE
Mailing Address - Street 2:APT 1202
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6554
Mailing Address - Country:US
Mailing Address - Phone:301-469-9202
Mailing Address - Fax:
Practice Address - Street 1:7420 WESTLAKE TER
Practice Address - Street 2:APT 1202
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-6554
Practice Address - Country:US
Practice Address - Phone:301-469-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD029031041C0700X
DCLC3003091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical