Living Light Llc | |
120 Mohegan Dr Unit C Havre De Grace MD 21078-2698 | |
(410) 942-1235 | |
Not Available |
Full Name | Living Light Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 120 Mohegan Dr, Havre De Grace, Maryland |
Authorized Official Name and Position | Ayana Burnett (SOLE MEMBER) |
Authorized Official Contact | 4109421235 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Living Light Llc 120 Mohegan Dr Unit C Havre De Grace MD 21078-2698 Ph: (410) 942-1235 | Living Light Llc 120 Mohegan Dr Unit C Havre De Grace MD 21078-2698 Ph: (410) 942-1235 |
NPI Number | 1639592215 |
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Provider Enumeration Date | 02/02/2014 |
Last Update Date | 02/02/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639592215 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 15444 (Maryland) | Primary |
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