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Individual

MRS. BRENDA DORSCH IBUTU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
3902 ANNAPOLIS RD, LANSDOWNE, MD 21227-2249
(410) 789-2647
(410) 789-8364
Mailing address
3902 ANNAPOLIS RD, LANSDOWNE, MD 21227-2249
(410) 789-6247
(410) 789-8364

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC3573
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3573
MD
101YM0800X
Mental Health Counselor
Primary
LC3573
MD
101YP1600X
Pastoral Counselor
LC3573
MD
101YP2500X
Professional Counselor
LC3573
MD

Other

Enumeration date
12/15/2010
Last updated
12/15/2010
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