Individual
MS. CARLY MARIE WHITLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
626 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3320
(410) 939-8744
(410) 939-8748
Mailing address
626 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3320
(410) 939-8744
(410) 939-8748
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC5377
MD
Other
Enumeration date
02/15/2012
Last updated
10/28/2013
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