Individual
MIRAN DALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12 S SUMMIT AVE STE 100-A6, GAITHERSBURG, MD 20877-2089
(301) 818-6000
Mailing address
12 S SUMMIT AVE STE 100-A40, GAITHERSBURG, MD 20877-2089
(301) 818-8182
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0704015005
VA
101YM0800X
Mental Health Counselor
LC14005
MD
101YP2500X
Professional Counselor
0704015005
VA
101YP2500X
Professional Counselor
Primary
LC14005
MD
Other
Enumeration date
08/23/2022
Last updated
02/26/2025
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