Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC0238 | MD |
NPI | 1003194952 |
---|---|
Provider Name | Mrs. Lucretia Ruth Pizzano |
First Address | Damascus, MD 20872-1304 |
Second Address | Damascus, MD 20872-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2011 |
Last Update Date | 26/07/2011 |