Individual
MRS. LAURA MENNECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
479 JUMPERS HOLE ROAD, SUITE 304B, SEVERNA PARK, MD 21146
(410) 693-7171
Mailing address
479 JUMPERS HOLE RD STE 304B, SEVERNA PARK, MD 21146-1732
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC6877
MD
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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