Organization
LIVING LIGHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYANA BURNETT (SOLE MEMBER)
(410) 942-1235
Entity
Organization
Contact information
Practice address
120 MOHEGAN DR, UNIT C, HAVRE DE GRACE, MD 21078-2698
(410) 942-1235
Mailing address
120 MOHEGAN DR, UNIT C, HAVRE DE GRACE, MD 21078-2698
(410) 942-1235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15444
MD
Other
Enumeration date
02/02/2014
Last updated
02/02/2014
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