Individual
NATHANIEL EUGENE CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
8109 HARFORD RD, PARKVILLE, MD 21234-9205
(410) 665-2900
Mailing address
5345 GLEN ARM RD, GLEN ARM, MD 21057-9302
(410) 688-0157
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC1978
MD
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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