Doctor Name: | NANCY JULIA |
NPI Number: | 1043360795 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | |
Business Practice Address: | 109 W Bel Air Ave Aberdeen, MD - 210013221 |
Business Phone Number: | 4102972271 |
Business Fax Number: | |
Mailing Address: | 1711 Aberdeen Rd, PARKVILLE |
State: | MD |
Postal Code: | 212345142 |
Phone Number: | 3013854696 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 10/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |