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General NPI Number Information
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NPI Number | 1043810682
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Entity Type | Individual
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Provider Name | AGNES MACHARIA
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Gender | Female
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 1208 E CHURCHVILLE RD
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City | BEL AIR
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State | MD
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Zip | 21014-3442
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Country | US
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Telephone | 410-893-4600
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Fax | 443-640-4358
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Provider Business Mailing Address
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Address Line | 28 BRAMPTON CT
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6432
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Country | US
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Telephone | 443-867-0608
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LGP10574
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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 | LC12774
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License Number State | MD
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