Individual
PATRICK GOLLEGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LGPC, CAC-AD
Contact information
Practice address
3003 HOSPITAL DR, CHEVERLY, MD 20785-1194
(301) 583-5920
Mailing address
3003 HOSPITAL DR, CHEVERLY, MD 20785-1194
(301) 583-5920
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LGP5092
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
AC1192
MD
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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