Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LC4135 | MD |
NPI | 1003058298 |
---|---|
Provider Name | Ilana Meiller |
First Address | Reisterstown, MD 21136-1236 |
Second Address | Reisterstown, MD 21136-1236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 07/05/2013 |