Organization
LEGACY FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA T DUDLEY HAMILTON LCPC (OWNER)
(202) 746-4345
Entity
Organization
Contact information
Practice address
11415 OLD POND DR, GLENN DALE, MD 20769-9154
(301) 200-2919
Mailing address
11415 OLD POND DR, GLENN DALE, MD 20769-9154
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EM58-0000
CAREFIRST
—
Enumeration date
10/01/2020
Last updated
10/01/2020
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