Provider Demographics
NPI:1265706378
Name:BAILEY-KLOCH, MARIE (MSW)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:BAILEY-KLOCH
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 1:406 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2639
Mailing Address - Country:US
Mailing Address - Phone:443-883-5741
Mailing Address - Fax:
Practice Address - Street 1:10 S. PINE ST MSTF 360C
Practice Address - Street 2:UNIVERSITY OF MARYLAND
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-706-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD053431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical