Provider Demographics
NPI:1609643691
Name:SANABRIA, ELIZABETH ANGELA
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANGELA
Last Name:SANABRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19629 GALWAY BAY CIR APT 404
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4615
Mailing Address - Country:US
Mailing Address - Phone:240-723-0984
Mailing Address - Fax:
Practice Address - Street 1:19315 ARCHDALE RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-1601
Practice Address - Country:US
Practice Address - Phone:240-740-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD263521041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool