Individual
ERICA D SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23077 THREE NOTCH RD STE 302, CALIFORNIA, MD 20619-2453
(240) 237-8338
Mailing address
23077 THREE NOTCH RD STE 302, CALIFORNIA, MD 20619-2453
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
300225
MD
101YM0800X
Mental Health Counselor
—
MD
101YP2500X
Professional Counselor
Primary
LGP5537
MD
101YS0200X
School Counselor
1870
MD
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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