Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | LC1671 | MD |
NPI | 1326258914 |
---|---|
Provider Name | Tina Leigh Lightner-Morris |
First Address | Gaithersburg, MD 20879-4563 |
Second Address | Gaithersburg, MD 20877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |