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General NPI Number Information
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NPI Number | 1285641050
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Entity Type | Individual
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Provider Name | MICHELLE PATRICE LANDERS LGPC
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | KEY POINT HEALTH SERVICES 7702 DUNMANWAY
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City | BALTIMORE
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State | MD
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Zip | 21222
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Country | US
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Telephone | 410-282-1792
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Fax |
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Provider Business Mailing Address
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Address Line | 1609 STEEPLECHASE DR
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City | JARRETTSVILLE
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State | MD
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Zip | 21084-2005
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Country | US
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Telephone | 410-688-4189
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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 | LGP076
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License Number State | MD
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