Healthcare Provider Details

I. General information

NPI: 1538328265
Provider Name (Legal Business Name): ANNE J LOOVIS L.C.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10709 BIRMINGHAM WAY
WOODSTOCK MD
21163-1403
US

IV. Provider business mailing address

10709 BIRMINGHAM WAY
WOODSTOCK MD
21163-1403
US

V. Phone/Fax

Practice location:
  • Phone: 410-203-9016
  • Fax: 410-418-4665
Mailing address:
  • Phone: 410-203-9016
  • Fax: 410-418-4665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC2193
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: