Individual
MS. BOBBI LEE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
11 W 3RD ST, FREDERICK, MD 21701-5330
(410) 419-9517
(800) 725-4214
Mailing address
5717 CHASE CT, FREDERICK, MD 21703-2821
(410) 419-9517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2053
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4118146-00
MARYLAND MEDICAL ASSISTAN
MD
Enumeration date
07/10/2007
Last updated
02/22/2012
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