CHANGING GENERATIONAL LEGACIESLLC NPI 1598012155

NPI Information

CHANGING GENERATIONAL LEGACIES,LLC is a professional counselor in Largo, MD. CHANGING GENERATIONAL LEGACIES,LLC NPI is 1598012155. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1401 MERCANTILE LN
SUITE 200-Q
LARGO, MD
ZIP 20774-301
Phone: (301) 322-4141
Fax: (301) 322-9199

The provider's authorized official is Debra Joyce Johnson .
The authorized official title is Ceo, Founder and has the following contact phone number (301) 322-4141.

The enumeration date for this NPI number is 8/13/2012 and was last updated on 8/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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