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Individual

ANGELA TOSCANO DOMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
135 N PARKE ST, ABERDEEN, MD 21001-2428
(443) 625-1570
Mailing address
135 N PARKE ST, ABERDEEN, MD 21001-2428
(443) 625-1570

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
LC9365
MD
101YP2500X
Professional Counselor
LGP7829
MD

Other

Enumeration date
07/07/2014
Last updated
07/21/2022
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