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General NPI Number Information
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NPI Number | 1134980964
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Entity Type | Individual
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Provider Name | EMILY SMALL NCC, LGPC, MS, BS
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Gender | Female
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 1144 SYKESVILLE RD
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City | SYKESVILLE
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State | MD
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Zip | 21784-5418
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Country | US
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Telephone | 667-324-9484
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Fax |
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Provider Business Mailing Address
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Address Line | 14050 MONTICELLO DR
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City | COOKSVILLE
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State | MD
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Zip | 21723-9614
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Country | US
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Telephone | 443-315-6233
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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 | LGP14729
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License Number State | MD
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