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Individual

ANITA M ROY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LCPC, NCC

Contact information

Practice address
6131 EXECUTIVE BLVD, ROCKVILLE, MD 20852-3901
(256) 710-3413
Mailing address
7444 OTTENBROOK TER, ROCKVILLE, MD 20855-1988
(256) 710-3413

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
LC8943
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515-05962
BCBS OF AL
AL
Enumeration date
05/15/2007
Last updated
10/04/2019
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