Individual
MARIE MARCELLE BRIARD VANTELAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC, ADT
Contact information
Practice address
907 SETON DR, CUMBERLAND, MD 21502-1817
(301) 777-0633
Mailing address
780 BISHOP WALSH RD, CUMBERLAND, MD 21502-1802
(732) 850-5977
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADT2497
MD
101YP2500X
Professional Counselor
Primary
LGP13227
MD
Other
Enumeration date
10/14/2022
Last updated
02/01/2023
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