Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LGP7460 | MD |
NPI | 1003374646 |
---|---|
Provider Name | Laura Scott |
First Address | Baltimore, MD 21218-3912 |
Second Address | Baltimore, MD 21211-2145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2019 |
Last Update Date | 02/03/2019 |