Individual
MR. THANE STIELOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMFT
Contact information
Practice address
3600 MAUREEN LANE, BOWIE, MD 20715
(301) 802-1159
Mailing address
3600 MAUREEN LN, BOWIE, MD 20715-2936
(301) 802-1159
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LCM206
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58956180
—
MD
Enumeration date
04/03/2007
Last updated
04/08/2014
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