Individual
MR. MICHAEL W. NETTLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1858 ROCHELLE AVE, CAPITOL HEIGHTS, MD 20743-4306
(202) 247-1999
(301) 513-0181
Mailing address
5206 MINEOLA RD, COLLEGE PARK, MD 20740-4612
(202) 247-1999
(301) 513-0181
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC4560
MD
101YP2500X
Professional Counselor
PRC14104
DC
Other
Enumeration date
08/17/2012
Last updated
08/17/2012
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