Individual
CHANELL GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9752 WESTPHALIA ST, WALDORF, MD 20603-5365
(703) 627-9773
Mailing address
9752 WESTPHALIA ST, WALDORF, MD 20603-5365
(703) 627-9773
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PRC14169
DC
Other
Enumeration date
07/22/2016
Last updated
08/02/2024
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