Individual
JESSICA LEIGH LASTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
306 N MARKET ST APT 2-1, FREDERICK, MD 21701-5337
(240) 446-3238
Mailing address
306 N MARKET ST APT 2-1, FREDERICK, MD 21701-5337
(240) 446-3238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP11409
MD
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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