Individual
MARY ELIZABETH SEREY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LC-PC
Contact information
Practice address
81 W FREDERICK ST, WALKERSVILLE, MD 21793-8216
(240) 236-7200
Mailing address
191 S EAST ST, FREDERICK, MD 21701-5918
(240) 236-7200
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2304
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC2304
LICENSED CLINICAL PROFESSIONAL COUNSELOR
MD
Enumeration date
12/06/2018
Last updated
12/06/2018
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