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General NPI Number Information
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NPI Number | 1669957668
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Entity Type | Individual
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Provider Name | GISELA DE LA PENA BAPTISTE LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 8640 GUILFORD RD STE 251
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City | COLUMBIA
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State | MD
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Zip | 21046-2665
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Country | US
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Telephone | 419-992-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 10447 FAIR OAKS
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City | COLUMBIA
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State | MD
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Zip | 21044-4143
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Country | US
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Telephone | 410-992-2224
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC4436
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License Number State | MD
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