Individual
LAURA LYNN FANTACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
604 SOLAREX CT, SUITE 201, FREDERICK, MD 21703-7005
(301) 663-8263
(301) 682-5326
Mailing address
604 SOLAREX CT, SUITE 201, FREDERICK, MD 21703-7005
(301) 663-8263
(301) 682-5326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC4897
MD
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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