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General NPI Number Information
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NPI Number | 1033707310
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Entity Type | Individual
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Provider Name | ANN LORRY NATHALIE MARCELIN LGPC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 620 E DIAMOND AVE STE H
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City | GAITHERSBURG
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State | MD
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Zip | 20877-5328
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Country | US
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Telephone | 240-683-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 12965 PINNACLE DR APT 103
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City | GERMANTOWN
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State | MD
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Zip | 20874-9104
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP10140
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License Number State | MD
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