Individual
STACEY KATHERYN LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
3060 MICHELLVILLE RD, SUITE 106, BOWIE, MD 20716
(410) 893-4600
(443) 640-4358
Mailing address
7316 BRAMBLEBUSH TER, LAUREL, MD 20707-9514
(646) 532-8486
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LGP8365
MD
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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