Individual
ANDA DIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
8120 WOODMONT AVE STE 840, BETHESDA, MD 20814-2789
(240) 618-2889
Mailing address
56 CATOCTIN CT, SILVER SPRING, MD 20906-2005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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