Doctor Name: | MRS. LISA ANN MAHER |
NPI Number: | 1003119892 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC3405 |
Business Practice Address: | 30 Greenway St Nw Suite 5 Glen Burnie, MD - 210613557 |
Business Phone Number: | 4107609079 |
Business Fax Number: | |
Mailing Address: | 30 Greenway St Nw, Suite 5 GLEN BURNIE |
State: | MD |
Postal Code: | 210613557 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/16/2010 |
NPI Last Update Date: | 12/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LC3405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |