| N/a | |
|
14007 Buck Ct Upper Marlboro MD 20772-6821 | |
| (301) 922-1334 | |
| (301) 627-7421 |
| Full Name | N/a |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 14007 Buck Ct, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Dale R Williams (LICENSED CLINICAL PROFESSIONAL COUN) |
| Authorized Official Contact | 3016270399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 14007 Buck Ct Upper Marlboro MD 20772-6821 Ph: (301) 922-1334 | N/a 14007 Buck Ct Upper Marlboro MD 20772-6821 Ph: (301) 922-1334 |
| NPI Number | 1033156971 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033156971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCO307 (Maryland) | Primary |
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