Individual provider · Type 1 NPI
Justin Deitrick, LGPC
Professional Counselor · Glenwood, MD
NPI number
1417660663
Active
Practice location
3700 Championship Dr
Glenwood, MD 21738-9311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| School Counselor | 101YS0200X | None listed |
| Professional Counselor Primary | 101YP2500X | LGP1399 (MD) |
Professional Counselor: Definition to come...
About NPI 1417660663
Justin Deitrick, LGPC's National Provider Identifier is 1417660663, issued on Jan 3, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Glenwood, MD. The record was last updated on Jan 3, 2023.