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General NPI Number Information
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NPI Number | 1780220541
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Entity Type | Individual
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Provider Name | ELIZA JANE HUIE LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 2600 MARRIOTTSVILLE RD
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104-1628
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Country | US
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Telephone | 443-419-3884
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Fax |
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Provider Business Mailing Address
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Address Line | 27237 RIDGE RD
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City | DAMASCUS
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State | MD
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Zip | 20872-1049
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Country | US
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Telephone | 661-805-8235
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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 | LC10016
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License Number State | MD
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