Provider Demographics
NPI:1508198789
Name:COFIELD-ABER, VICTORIA M
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:M
Last Name:COFIELD-ABER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:COFIELD-ABER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLINICAL SOCIAL WORK
Mailing Address - Street 1:5074 DORSEY HALL DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7792
Mailing Address - Country:US
Mailing Address - Phone:410-730-1312
Mailing Address - Fax:410-730-1312
Practice Address - Street 1:5074 DORSEY HALL
Practice Address - Street 2:SUITE 104
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:410-730-1312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD047141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAI1989Medicaid
MDMI1980Medicaid
MDAL8089Medicare PIN