Healthcare Provider Details

I. General information

NPI: 1316297971
Provider Name (Legal Business Name): CLAUDIA ESTRADA-SOLARES LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 BANNEKER RD
COLUMBIA MD
21044-3103
US

IV. Provider business mailing address

15513 PEACH ORCHARD RD
SILVER SPRING MD
20905-4347
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-2385
  • Fax:
Mailing address:
  • Phone: 443-295-3718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP4567
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: