Provider Demographics
NPI:1831258532
Name:PATTERSON, VERA JEAN (LGSW)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:JEAN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 BLUE HERON WAY
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:MD
Mailing Address - Zip Code:21822
Mailing Address - Country:US
Mailing Address - Phone:410-860-2422
Mailing Address - Fax:
Practice Address - Street 1:9730 HEALTHWAY DRIVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-629-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG09010104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker