Mordecai Andemichael
Counselor in Laurel, MD. Individual provider (NPI-1).
NPI number1164057675
StatusActive
Last updated in NPPESMar 4, 2020
Details
- NPI
- 1164057675
- Entity type
- Individual (NPI-1)
- Name
- Mordecai Andemichael
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2020
- Certification date
- Mar 4, 2020
- Last updated
- Mar 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
9660 Iron Leaf TrlLaurel, MD 20723-5878
Phone 301-490-1011
Mailing address
7885 King Arthur CtWhite Plains, MD 20695-3429
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