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Individual

MRS. TATIANA MIKHAILOVNA GURUBATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LGPC

Contact information

Practice address
700 MELVIN AVE STE 5, ANNAPOLIS, MD 21401-1506
(410) 280-9444
Mailing address
210 EVANS AVE, GRASONVILLE, MD 21638-1207
(240) 638-6021

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP14320
MD

Other

Enumeration date
12/18/2023
Last updated
12/18/2023
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