Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LC3405 | MD |
NPI | 1003119892 |
---|---|
Provider Name | Mrs. Lisa Ann Maher |
First Address | Glen Burnie, MD 21061-3557 |
Second Address | Glen Burnie, MD 21061-3557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2010 |
Last Update Date | 16/12/2010 |