Healthcare Provider Details

I. General information

NPI: 1659275212
Provider Name (Legal Business Name): MRS. MOLLY DANIELLE DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5457 TWIN KNOLLS RD
COLUMBIA MD
21045-3259
US

IV. Provider business mailing address

2935 DILLON ST
BALTIMORE MD
21224-4834
US

V. Phone/Fax

Practice location:
  • Phone: 240-363-4181
  • Fax:
Mailing address:
  • Phone: 410-428-1932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP16262
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: