Individual
SHARDELL I VIATONU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6495 NEW HAMPSHIRE AVE # A303, HYATTSVILLE, MD 20783-3245
(240) 432-8352
Mailing address
8111 BETHEL LN, SAVAGE, MD 20763-5548
(240) 432-8352
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC7979
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502121900
—
MD
Enumeration date
11/04/2015
Last updated
07/25/2024
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