Individual
MRS. NICOLE LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7400 YORK RD, SUITE #303, BALTIMORE, MD 21204-7531
(410) 828-6656
Mailing address
7400 YORK RD, SUITE #303, BALTIMORE, MD 21204-7531
(410) 828-6656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
W10821023
MD
Other
Enumeration date
05/07/2007
Last updated
07/09/2007
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