Individual
ANTONIO KALLUNGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18317 WINTER PARK CT, GAITHERSBURG, MD 20879-4626
(703) 705-2476
Mailing address
18317 WINTER PARK CT, GAITHERSBURG, MD 20879-4626
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704014134
VA
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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