Individual
PHYLLIS LAURA FAGELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5272 RIVER RD STE 510, BETHESDA, MD 20816-1457
(301) 213-3997
Mailing address
8202 THOREAU DR, BETHESDA, MD 20817-3162
(301) 213-3997
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC4921
MD
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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