Individual
DIANE MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCAD-C
Contact information
Practice address
1721 PENNSYLVANIA AVE # 205, BALTIMORE, MD 21217-3119
(443) 869-6041
Mailing address
1721 PENNSYLVANIA AVE # 205, BALTIMORE, MD 21217-3119
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCA268
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCA268
LICENSE NUMBER
MD
Enumeration date
04/19/2020
Last updated
04/19/2020
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