Individual
MR. SHANE TYLER HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3000
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC8801
MD
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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