Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC2750 | MD |
NPI | 1003242983 |
---|---|
Provider Name | Lajoy Robin Preston |
First Address | Mitchellville, MD 20721-2358 |
Second Address | Largo, MD 20774-5327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2013 |
Last Update Date | 23/09/2013 |