Individual
MARISSA MIARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
5022 CAMPBELL BLVD # 4969, NOTTINGHAM, MD 21236-4969
(443) 442-1568
Mailing address
1413 RACE ST, BALTIMORE, MD 21230-4412
(269) 303-2130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP11736
MD
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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