Individual
MRS. ELISA S. CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
604 S FREDERICK AVE, SUITE 211, GAITHERSBURG, MD 20877-1275
(774) 573-1512
Mailing address
9112 SEWARD ST, FREDERICK, MD 21704-7921
(774) 573-1512
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC3301
MD
106H00000X
Marriage & Family Therapist
52859
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/21/2007
Last updated
06/19/2012
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