Individual
SHAE R TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
120 WATERFRONT ST #2300, STE 420, NATIONAL HARBOR, MD 20745-1122
(301) 778-8566
Mailing address
120 WATERFRONT ST #2300, STE 420, NATIONAL HARBOR, MD 20745-1122
(301) 778-8566
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC12935
MD
101YP2500X
Professional Counselor
PRC200001564
DC
Other
Enumeration date
11/27/2020
Last updated
12/06/2024
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