Individual
NICHOLE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 E CHURCHVILLE RD STE 301, BEL AIR, MD 21014-3482
(443) 640-4913
Mailing address
21299 DUNK FREELAND RD, PARKTON, MD 21120-9270
(443) 465-8994
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC9510
MD
Other
Enumeration date
11/08/2014
Last updated
07/19/2024
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