Individual
ANNASTASIA KATHLEEN KEZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CSS, LCPC
Contact information
Practice address
4940 EASTERN AVENUE, COMMUNITY PSYCHIATRY PROGRAM, BALTIMORE, MD 21224
(410) 550-2996
Mailing address
4940 EASTERN AVENUE, COMMUNITY PSYCHIATRY PROGRAM, BALTIMORE, MD 21224
(410) 550-2996
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC0430
MD
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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