Doctor Name: | VICTORIA LYNN ANTAL |
NPI Number: | 1245698844 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC6687 |
Business Practice Address: | 1716 Harford Rd Suite 204 Fallston, MD - 210472643 |
Business Phone Number: | 4108777207 |
Business Fax Number: | 4108777224 |
Mailing Address: | 1716 Harford Rd, Suite 204 FALLSTON |
State: | MD |
Postal Code: | 210472643 |
Phone Number: | 4108777207 |
Fax Number: | 4108777224 |
NPI Enumeration Date: | 02/10/2016 |
NPI Last Update Date: | 02/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LC6687 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |