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Individual

BARBARA BAZEMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12 S SUMMIT AVE STE 100, GAITHERSBURG, MD 20877-2090
(301) 517-6463
Mailing address
460 BLOSSOM LN, FREDERICK, MD 21701-1228
(702) 372-7580

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LGPC7715
MD
101YP2500X
Professional Counselor
Primary
LC13686
MD

Other

Enumeration date
11/18/2019
Last updated
03/15/2023
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