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Individual

MARCIA J NETHERLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, NCC, LPC, TF-CBT

Contact information

Practice address
14734 AMBERJACK TER, LAKEWOOD RANCH, FL 34202-5800
(717) 658-0581
Mailing address
14734 AMBERJACK TER, LAKEWOOD RANCH, FL 34202-5800
(717) 658-0581

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2019024180
MO
101YP2500X
Professional Counselor
PC006365
PA
103K00000X
Behavior Analyst

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102992907
PA
Enumeration date
05/25/2010
Last updated
02/16/2023
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