Individual
MS. STEPHANIE P. BATHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCMFT
Contact information
Practice address
12501 PROSPERITY DR STE 310, SILVER SPRING, MD 20904-1699
(240) 780-8884
Mailing address
21 DEEP POWDER COURT, WOODSTOCK, MD 21163
(215) 692-2461
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LCM585
MD
106H00000X
Marriage & Family Therapist
LGM501
MD
Other
Enumeration date
03/07/2016
Last updated
11/22/2020
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