Individual
NWABU PHENDULU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
15523 GLASTONBURY WAY, UPPER MARLBORO, MD 20774-8033
(703) 599-7323
Mailing address
15523 GLASTONBURY WAY, UPPER MARLBORO, MD 20774-8033
(703) 599-7323
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP13105
MD
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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