Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LC4264 | MD |
N | 101YP2500X | Professional Counselor | LGP3435 | MD |
N | 101YS0200X | School Counselor | 06-8068 | MD |
NPI | 1235441247 |
---|---|
Provider Name | Ms. Susan R Mcfadden |
First Address | Finksburg, MD 21048-1118 |
Second Address | Finksburg, MD 21048-1118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2010 |
Last Update Date | 21/01/2012 |