Doctor Name: | MRS. SHARILYN DENISE CONNALLY |
NPI Number: | 1043469430 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LGPC |
License Number: | LGP294 |
Business Practice Address: | 9320 Annapolis Rd Ste 100 Lanham, MD - 207063122 |
Business Phone Number: | 3015778152 |
Business Fax Number: | |
Mailing Address: | 12100 Sand Wedge Ln, UPPER MARLBORO |
State: | MD |
Postal Code: | 207727965 |
Phone Number: | 2402441787 |
Fax Number: | |
NPI Enumeration Date: | 09/10/2008 |
NPI Last Update Date: | 09/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LGP294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |