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Individual

MICHAEL ETTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW-C, ACH

Contact information

Practice address
109 LA GRANGE AVE, SUITE 102, LA PLATA, MD 20646-9592
(240) 253-7051
(301) 934-2640
Mailing address
109 LA GRANGE AVE, SUITE 102, LA PLATA, MD 20646-9592
(240) 253-7051
(301) 934-2640

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15506
MD

Other

Enumeration date
08/14/2008
Last updated
05/02/2012
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