Individual
MS. PHYLLIS ANNETTE HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
4101 OLD YORK RD, BALTIMORE, MD 21218-1237
(410) 433-1458
Mailing address
949 GORSUCH AVE, BALTIMORE, MD 21218-3602
(410) 467-4121
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1640
MD
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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