Individual
MARICIELO LEASURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
305 W PENNSYLVANIA AVE, TOWSON, MD 21204-4413
(443) 300-6905
Mailing address
610 FOXCROFT DR, BEL AIR, MD 21014-4433
(801) 472-2434
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP16596
MD
Other
Enumeration date
06/14/2025
Last updated
06/16/2025
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