person
Champ Moultrie
Professional Counselor in Laurel, Maryland
NPI 1699437822

Champ Moultrie is a Professional Counselor based in Severn, MD and is specialized in Professional. Champ Moultrie practices in Laurel, MD. The NPI Number for Champ Moultrie is 1699437822 and holds a License No. LGP10255 (Maryland).

The current practice location address for Champ Moultrie is 9660 Iron Leaf Trl, Laurel, MD and can be reached out via phone at 443-687-6827. You can also correspond with Champ Moultrie through the mailing address at 7914 BENTBOUGH RD, SEVERN, MD - 21144-1077 (mailing address contact number: 443-687-6827).

Location: 9660 Iron Leaf Trl, Laurel, MD, 21144-1077
person
Provider Profile Details
NPI Number
1699437822
Provider Name
Champ Moultrie
Credential
Provider Entity Type
Individual
Gender
Male
Address
9660 Iron Leaf Trl, Laurel, MD, 21144-1077
Phone Number
443-687-6827
Fax Number
Provider Enumeration Date
10/05/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9660 Iron Leaf Trl
City
State
Zip
20723-5878
Phone Number
443-687-6827
Fax Number
person
Provider Business Mailing Address Details
Address
9660 Iron Leaf Trl
City
State
Zip
20723-5878
Phone Number
443-687-6827
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LGP10255 (Maryland)
Definition
Definition to come...
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