Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | LC3077 | MD |
Y | 101YP2500X | Professional Counselor | LC3077 | MD |
NPI | 1306079769 |
---|---|
Provider Name | Ms. Jacqueline Ann Stilling |
First Address | Towson, MD 21204-4421 |
Second Address | Towson, MD 21204-4421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2009 |
Last Update Date | 01/03/2015 |