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NPI Code Detail

MEDICARE: MRS. LAURA PRZYBYLEK M.S.

MEDICARE: MRS. LAURA PRZYBYLEK M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLGP9193

General Provider Information

NPI Number : 1639649361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA PRZYBYLEK M.S.
Provider Business Mailing Address
First Line : 1416 VILLAGE OAKS CT
Second Line :
City : MOUNT AIRY
State : MD
Zip : 21771-5316
Country : US
Telephone Number : 301-639-2517
Fax Number :
Provider Business Practice Location Address
First Line : 11670 OLD NATIONAL PIKE STE 103
Second Line :
City : NEW MARKET
State : MD
Zip : 21774-6123
Country : US
Telephone Number : 301-865-2226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2018
Last Update Date : 11/26/2018

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