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NPI Code Detail

MEDICARE: MRS. DORMELIA AVENT LCPC

MEDICARE: MRS. DORMELIA AVENT LCPC
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
1101YP2500XProfessional CounselorLC2882MD

General Provider Information

NPI Number : 1891943551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DORMELIA AVENT LCPC
Provider Business Mailing Address
First Line : 3420 WOODSTOCK AVE
Second Line :
City : BALTIMORE
State : MD
Zip : 21213-1123
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3106 HARFORD RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21218-3114
Country : US
Telephone Number : 443-791-4607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2008
Last Update Date : 09/05/2008

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Directions to “ MRS. DORMELIA AVENT LCPC” Practice Location

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