| None | |
|
201 Prospect Ave Suite 103 Hagerstown MD 21742-3204 | |
| (240) 382-2207 | |
| (240) 347-4831 |
| Full Name | None |
|---|---|
| Speciality | Counselor - Professional |
| Location | 201 Prospect Ave, Hagerstown, Maryland |
| Authorized Official Name and Position | John Charles Brown (OWNER) |
| Authorized Official Contact | 2403822207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 201 Prospect Ave Suite 103 Hagerstown MD 21742-3204 Ph: (240) 382-2207 | None 201 Prospect Ave Suite 103 Hagerstown MD 21742-3204 Ph: (240) 382-2207 |
| NPI Number | 1013332410 |
|---|---|
| Provider Enumeration Date | 02/22/2014 |
| Last Update Date | 02/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013332410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LCPC 1159 (Maryland) | Primary |
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