Individual
CANDACE DOMAYER ELLRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
10455 FALLS RD, LUTHERVILLE, MD 21093-3614
(410) 292-1115
Mailing address
10455 FALLS RD, LUTHERVILLE, MD 21093-3614
(410) 292-1115
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC4025
MD
Other
Enumeration date
06/10/2011
Last updated
08/17/2011
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