Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC0880 | MD |
NPI | 1003020801 |
---|---|
Provider Name | Mr. Carl Robbins |
First Address | Towson, MD 21204-6872 |
Second Address | Towson, MD 21204-6872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |