Provider Demographics
NPI:1891830733
Name:CHIODI-HICKS, ROSALYN (BS,CACAD)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:CHIODI-HICKS
Suffix:
Gender:F
Credentials:BS,CACAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 FRANKLIN SQUARE DR
Mailing Address - Street 2:SUITE322
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9100 FRANKLIN SQUARE DR
Practice Address - Street 2:SUITE322
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3903
Practice Address - Country:US
Practice Address - Phone:410-887-6465
Practice Address - Fax:410-687-6005
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0595101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)