Individual
JEANINNE MARIE BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
17197 HARDY RD, MOUNT AIRY, MD 21771-3216
(443) 413-3896
Mailing address
17197 HARDY RD, MOUNT AIRY, MD 21771-3216
(443) 413-3896
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP17166
MD
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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