Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC1632 | MD |
NPI | 1003472267 |
---|---|
Provider Name | Kathy Weikert |
First Address | Baltimore, MD 21287-0016 |
Second Address | Baltimore, MD 21287-0016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2019 |
Last Update Date | 14/05/2019 |