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Individual

KATRINA COLLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
915 CLOPPER RD APT A3, GAITHERSBURG, MD 20878-1237
(240) 543-3748
(240) 715-9673
Mailing address
915 CLOPPER RD APT A3, GAITHERSBURG, MD 20878-1237

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2826
MD
106H00000X
Marriage & Family Therapist
LCM363
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
274712233
IRS DEPARTMENT OF TREASURY
MD
Enumeration date
03/02/2011
Last updated
03/02/2011
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