Most Relevant Information
Provider Data
| NPI Number: | 1003291493 |
| Provider Name: | EDWARD PECUKONIS MSW, PH.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 04642 |
Most Important Dates
| Enumeration Date: | 07/27/2015 |
| Last Updated: | 07/27/2015 |
Provider Practice Location
3244 DANMARK DR
GLENWOOD
MD
217389415
Practice Location Phone/Fax
| Phone: | 4104931530 |
| Fax: |
Provider Mailing Location
3244 DANMARK DR
GLENWOOD
MD
217389415
Provider Mailing Phone/Fax
| Phone: | 4104931530 |
| Fax: |