Individual
MARK SHROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10102 COUNTRY CLUB RD SE, CUMBERLAND, MD 21502-8339
(301) 777-2285
Mailing address
10102 COUNTRY CLUB RD SE, CUMBERLAND, MD 21502-8339
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT1636
MD
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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