Individual
MS. MARY M BAGBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6103 LORCOM CT, SPRINGFIELD, VA 22152-1320
(703) 569-8518
Mailing address
6103 LORCOM CT, SPRINGFIELD, VA 22152-1320
(703) 569-8518
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002092
VA
101YP2500X
Professional Counselor
LCO971
MD
Other
Enumeration date
06/22/2006
Last updated
07/08/2007
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