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Individual

KIRK WINGFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LGPC

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
LGP5022
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
589561800
MD
Enumeration date
05/22/2015
Last updated
05/22/2015
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