Individual provider · Type 1 NPI

Demitri Kornegay

Professional Counselor · Bowie, MD

NPI number 1417413253 Active

Practice location

12805 Vicar Woods Ln
Bowie, MD 20720-4770

Call (240) 876-3828 Map

Fax (301) 809-6194

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X9050 (MD)

Professional Counselor: Definition to come...

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About NPI 1417413253

Demitri Kornegay's National Provider Identifier is 1417413253, issued on Feb 18, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bowie, MD. The record was last updated on Feb 18, 2019.