Individual
MISS OMOLOLA VICTORIA IMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
2225 N CHARLES ST, BALTIMORE, MD 21218-5778
(410) 453-9553
Mailing address
7603 CHERT CT, GLEN BURNIE, MD 21060-8741
(301) 806-8012
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC12182
MD
101YP2500X
Professional Counselor
LGP9449
MD
101YP2500X
Professional Counselor
LGPC00489
DC
Other
Enumeration date
11/04/2019
Last updated
03/07/2022
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