Individual
MYSORE SHYAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 W WASHINGTON ST STE 503, HAGERSTOWN, MD 21740-4520
(301) 604-1458
Mailing address
20 W WASHINGTON ST STE 503, HAGERSTOWN, MD 21740-4520
(301) 393-3949
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP15819
MD
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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