Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | LC3049 | MD |
NPI | 1003251844 |
---|---|
Provider Name | Mr. Charles Patrick Lopresto |
First Address | Towson, MD 21204-7735 |
Second Address | Towson, MD 21204-7735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2013 |
Last Update Date | 07/05/2013 |