Individual
NYIA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, ADT
Contact information
Practice address
1014 WASHINGTON AVE, LA PLATA, MD 20646-4228
(240) 342-3240
Mailing address
8409 HOLLOW TREE LN UPPR MARLBORO, UPPER MARLBORO, MD 20772-9621
(301) 316-8230
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT3346
MD
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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