Individual
MRS. PATRICIA HAWKINS VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5411 HARVEST MOON LN, COLUMBIA, MD 21044-1806
(410) 730-9064
(410) 730-9064
Mailing address
5411 HARVEST MOON LN, COLUMBIA, COLUMBIA, MD 21044-1806
(410) 730-9064
(410) 730-9064
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
:LCO435
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52 2224354
MD STATE TAXPAYER IDENTIFICATION NUMBER
MD
Enumeration date
05/09/2008
Last updated
05/09/2008
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