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General NPI Number Information
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NPI Number | 1821691486
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Entity Type | Individual
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Provider Name | DOMENICA HOLZLE CARRESE LCMFT, MS
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 1 RESEARCH CT, STE 450
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 240-215-3517
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7611
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City | GAITHERSBURG
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State | MD
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Zip | 20898-7611
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM961
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License Number State | MD
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