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Individual

MS. DEIDRE RENEE EVERIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.P.C.

Contact information

Practice address
1406B CRAIN HWY S STE 301, GLEN BURNIE, MD 21061-4094
(410) 760-5588
Mailing address
4630 DOWER DR, ELLICOTT CITY, MD 21043-6406

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2441
MD

Other

Enumeration date
10/13/2007
Last updated
10/13/2007
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