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Richard Edward Deise Jr., LGPC

Counselor, Pastoral in Frederick, MD. Individual provider (NPI-1).

NPI number1669983607
StatusActive
Last updated in NPPESOct 17, 2017

Details

NPI
1669983607
Entity type
Individual (NPI-1)
Name
Richard Edward Deise Jr.
Credential
LGPC
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 17, 2017
Last updated
Oct 17, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP1600X Counselor, PastoralLGP3137MDYes

Practice location

226 S Jefferson St
Frederick, MD 21701-6205

Phone 301-663-6135

Mailing address

417 Wills Creek Dr
Brunswick, MD 21716-1840

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