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General NPI Number Information
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NPI Number | 1053938514
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Entity Type | Individual
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Provider Name | STEFANI COMER LGPC
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 1332 LONDONTOWN BLVD STE 119
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City | ELDERSBURG
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State | MD
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Zip | 21784-6587
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Country | US
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Telephone | 443-280-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 5835 PINE BROOK FARM RD
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City | SYKESVILLE
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State | MD
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Zip | 21784-8659
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Country | US
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Telephone | 443-280-5572
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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 | LGP10580
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License Number State | MD
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