MEDICARE: CLAUDIA ESTRADA-SOLARES LGPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LGP4567	MD

General Provider Information

NPI Number	:	1316297971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA ESTRADA-SOLARES LGPC

Provider Business Mailing Address
First Line	:	15513 PEACH ORCHARD RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20905-4347
Country	:	US
Telephone Number	:	443-295-3718
Fax Number	:

Provider Business Practice Location Address
First Line	:	5840 BANNEKER RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3103
Country	:	US
Telephone Number	:	410-730-2385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2012
Last Update Date	:	09/11/2012

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