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General NPI Number Information
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NPI Number | 1225527062
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Entity Type | Individual
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Provider Name | MARY KAMINSKI LGPC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 1 W CHURCH ST
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City | FREDERICK
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State | MD
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Zip | 21701-5991
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Country | US
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Telephone | 301-471-1416
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 232
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City | BRADDOCK HEIGHTS
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State | MD
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Zip | 21714-0232
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Country | US
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Telephone | 301-471-1416
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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 | LGP4753
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License Number State | MD
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