Organization
MAKONNEN THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RAEJON LYNNE MAKONNEN (OWNER)
(410) 422-3386
Entity
Organization
Contact information
Practice address
881 FLAGLER DR, GAITHERSBURG, MD 20878-1968
(410) 422-3386
Mailing address
881 FLAGLER DR, GAITHERSBURG, MD 20878-1968
(410) 422-3386
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC7426
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1143824
—
MD
Enumeration date
03/29/2017
Last updated
03/29/2017
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