Individual
RICHARD EDWARD DEISE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LGPC
Contact information
Practice address
226 S JEFFERSON ST, FREDERICK, MD 21701-6205
(301) 663-6135
Mailing address
417 WILLS CREEK DR, BRUNSWICK, MD 21716-1840
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
LGP3137
MD
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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