Individual
LAUREN ANNE BARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPAT
Contact information
Practice address
6100 RADIO STATION ROAD, LA PLATA, MD 20646
(301) 609-9887
(301) 609-9091
Mailing address
PO BOX 2924, LA PLATA, MD 20646-2984
(301) 609-9887
(301) 609-9091
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ATG058
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589561800
—
MD
Enumeration date
05/15/2014
Last updated
05/15/2014
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