Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP2500X | Professional Counselor | LC2920 | MD |
NPI | 1356420251 |
---|---|
Provider Name | Mary Ann Belote |
First Address | La Plata, MD 20646-9509 |
Second Address | Clinton, MD 20735-9665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 04/01/2009 |