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General NPI Number Information
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NPI Number | 1023589843
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Entity Type | Individual
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Provider Name | KELLY GUYTON
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Gender | Female
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 6535 N CHARLES ST STE 300
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City | BALTIMORE
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State | MD
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Zip | 21204-5824
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Country | US
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Telephone | 443-604-5988
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Fax | 410-427-3859
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Provider Business Mailing Address
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Address Line | 6535 N CHARLES ST STE 300
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City | BALTIMORE
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State | MD
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Zip | 21204-5824
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Country | US
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Telephone | 443-604-5988
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Fax | 410-427-3859
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGP9207
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC11622
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License Number State | MD
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