Individual
EDISON DAVID ICAZA GALARZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LGPC
Contact information
Practice address
1307 SEVEN LOCKS RD, ROCKVILLE, MD 20854-2909
(240) 777-9862
Mailing address
1307 SEVEN LOCKS RD, ROCKVILLE, MD 20854-2909
(240) 777-9862
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP14313
MD
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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