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General NPI Number Information
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NPI Number | 1346963840
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Entity Type | Individual
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Provider Name | LATRICE MCCOY
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Gender | Female
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 2905 MITCHELLVILLE RD STE 204
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City | BOWIE
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State | MD
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Zip | 20716-3961
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Country | US
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Telephone | 202-769-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 MITCHELLVILLE RD STE 204
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City | BOWIE
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State | MD
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Zip | 20716-3961
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Country | US
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Telephone | 202-769-4887
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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 | LGPC200001827
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LGP13106
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License Number State | MD
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