Healthcare Provider Details

I. General information

NPI: 1548621485
Provider Name (Legal Business Name): MARGARET O EARLE LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 E DIAMOND AVE SUITE 100
GAITHERSBURG MD
20877-5321
US

IV. Provider business mailing address

610 E DIAMOND AVE SUITE 100
GAITHERSBURG MD
20877-5321
US

V. Phone/Fax

Practice location:
  • Phone: 301-840-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP6189
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: