Individual
JENNIFER LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3409A URBANA PIKE, FREDERICK, MD 21704-7772
(240) 509-9767
Mailing address
6698 ROCKRIDGE PL, NEW MARKET, MD 21774-6617
(240) 344-4207
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1672
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1672
LCPC
MD
Enumeration date
04/06/2018
Last updated
04/06/2018
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