Individual
MRS. BRENDA MASSICOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9401 WHITE CEDAR DR, APT 309, OWINGS MILLS, MD 21117-7516
(410) 830-9113
Mailing address
1450 RANCHO GRANDE DR., HOUSTON, TX 77049
(410) 830-9113
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YM0800X
MD
172V00000X
Community Health Worker
172V00000X
MD
Other
Enumeration date
07/24/2013
Last updated
04/10/2023
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