Individual
MR. RALEIGH L BURCH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5419 DEALE CHURCHTON RD, SUITE 102, CHURCHTON, MD 20733-2404
(443) 607-6207
(443) 607-6208
Mailing address
5419 DEALE CHURCHTON RD, SUITE 102, CHURCHTON, MD 20733-2404
(443) 607-6207
(443) 607-6208
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCA034
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA034
MD
101YP2500X
Professional Counselor
Primary
LCA034
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415894600
—
MD
Enumeration date
03/14/2012
Last updated
03/14/2012
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