Provider Demographics
NPI:1750647772
Name:GIANOPLUS, PAULINE A (PHD, MSW, LCSW-C)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:A
Last Name:GIANOPLUS
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:786 FAIRVIEW AVE
Mailing Address - Street 2:E
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-2950
Mailing Address - Country:US
Mailing Address - Phone:443-699-4344
Mailing Address - Fax:
Practice Address - Street 1:786 E FAIRVIEW AVE, E
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403
Practice Address - Country:US
Practice Address - Phone:443-699-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151981041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1041C0700XOtherHEALTHCARE PROVIDER TAXONOMY CODE #1
OR120130724000667OtherPAC ADSIGNED BY PECOS