| Mala Mantis Counseling, Llc | |
|
2108 Brigade Cir Frederick MD 21702-2502 | |
| (443) 671-4509 | |
| Not Available |
| Full Name | Mala Mantis Counseling, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2108 Brigade Cir, Frederick, Maryland |
| Authorized Official Name and Position | Leeann Marie Randow (OWNER) |
| Authorized Official Contact | 4436714509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mala Mantis Counseling, Llc 2108 Brigade Cir Frederick MD 21702-2502 Ph: (443) 671-4509 | Mala Mantis Counseling, Llc 2108 Brigade Cir Frederick MD 21702-2502 Ph: (443) 671-4509 |
| NPI Number | 1487418513 |
|---|---|
| Provider Enumeration Date | 02/08/2024 |
| Last Update Date | 02/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487418513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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