Doctor Name: | NANCY LEE PICOU |
NPI Number: | 1043542582 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC2718 |
Business Practice Address: | 7305 Baltimore Ave College Park, MD - 207403234 |
Business Phone Number: | 2407522767 |
Business Fax Number: | 8662801536 |
Mailing Address: | 7305 Baltimore Ave, COLLEGE PARK |
State: | MD |
Postal Code: | 207403234 |
Phone Number: | 2407522767 |
Fax Number: | 8662801536 |
NPI Enumeration Date: | 02/09/2010 |
NPI Last Update Date: | 02/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC2718 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |