Individual
LINDA FIESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
104 FORBES ST STE 205, ANNAPOLIS, MD 21401-1598
(443) 604-1681
Mailing address
816 CHESTER AVE, ANNAPOLIS, MD 21403-3230
(443) 604-1681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC7804
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC7804
LICENSURE
MD
Enumeration date
01/02/2019
Last updated
01/02/2019
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