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Individual

TIA L GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
4 FARMINGHAM CT, APT. I, PARKVILLE, MD 21234-2086
(443) 904-9094
Mailing address
4 FARMINGHAM CT, APT. I, PARKVILLE, MD 21234-2086

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC4549
MD
101YP2500X
Professional Counselor
Primary
LC4549
MD

Other

Enumeration date
07/03/2015
Last updated
08/03/2023
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