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General NPI Number Information
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NPI Number | 1073121323
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Entity Type | Individual
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Provider Name | CHALLINA ROBERTS LGP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 4550 FORBES BLVD STE 330
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City | LANHAM
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State | MD
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Zip | 20706-6309
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Country | US
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Telephone | 301-609-9887
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Fax | 301-609-9091
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Provider Business Mailing Address
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Address Line | 4311 23RD PKWY APT 908
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-4462
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Country | US
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Telephone | 240-723-1067
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10186
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License Number State | MD
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