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Individual

MR. GAVIN ELIJAH MCCONNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LGPC

Contact information

Practice address
1025 MEMORIAL DR, OAKLAND, MD 21550-4343
(301) 334-7680
(301) 334-7681
Mailing address
PO BOX 158, GRANTSVILLE, MD 21536-0158
(240) 956-9650

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP15013
MD

Other

Enumeration date
04/29/2024
Last updated
10/18/2024
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