Individual
GLORI VANBRUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
23680 THREE NOTCH RD, SUITE 202B, HOLLYWOOD, MD 20636-3085
(240) 223-2451
(240) 223-2451
Mailing address
23680 THREE NOTCH RD, SUITE 202B, HOLLYWOOD, MD 20636-3085
(240) 223-2451
(240) 223-2451
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC5208
MD
101YM0800X
Mental Health Counselor
LC5208
MD
101YP2500X
Professional Counselor
Primary
LC5208
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440607900
—
MD
Enumeration date
12/03/2013
Last updated
05/01/2014
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