Individual
VIDA KORANTENG ADANSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP
Contact information
Practice address
1275B W PULASKI HWY, ELKTON, MD 21921-4719
(410) 620-7161
(410) 620-7168
Mailing address
1275B W PULASKI HWY, ELKTON, MD 21921-4719
(410) 620-7161
(410) 620-7168
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC9157
MD
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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