| Nicole Rudd, Lcpc | |
|
2905 Mitchellville Rd Ste 112 Bowie MD 20716-1321 | |
| (202) 406-0929 | |
| Not Available |
| Full Name | Nicole Rudd, Lcpc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2905 Mitchellville Rd Ste 112, Bowie, Maryland |
| Authorized Official Name and Position | Nicole Rudd (OWNER) |
| Authorized Official Contact | 2024060929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Rudd, Lcpc 2905 Mitchellville Rd Ste 112 Bowie MD 20716-1321 Ph: (202) 406-0929 | Nicole Rudd, Lcpc 2905 Mitchellville Rd Ste 112 Bowie MD 20716-1321 Ph: (202) 406-0929 |
| NPI Number | 1053906685 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 03/05/2021 |
| Certification Date | 02/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053906685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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