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Individual

MARK WHITAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8501 LASALLE ROAD, SUITE 115, TOWSON, MD 21286
(410) 337-7772
Mailing address
505 CEDARCROFT RD, BALTIMORE, MD 21212-2702

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP8418
MD

Other

Enumeration date
04/24/2019
Last updated
04/24/2019
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