Individual
BRYCE MATTHEW BLACKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LGPC
Contact information
Practice address
3003 TEAK LN, BOWIE, MD 20715-2041
(240) 274-1463
Mailing address
3003 TEAK LN, BOWIE, MD 20715-2041
(240) 274-1463
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP15994
MD
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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