Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC5009 | MD |
NPI | 1003248147 |
---|---|
Provider Name | Ms. Barbara J Wilson |
First Address | Bethesda, MD 20814-4043 |
Second Address | Gaithersburg, MD 20877-4039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2013 |
Last Update Date | 31/07/2013 |