Individual provider · Type 1 NPI

Champ Moultrie

Professional Counselor · Laurel, MD

NPI number 1699437822 Active

Practice location

9660 Iron Leaf Trl
Laurel, MD 20723-5878

Call (443) 687-6827 Map

Mailing address

7914 Bentbough Rd
Severn, MD 21144-1077

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLGP10255 (MD)

Professional Counselor: Definition to come...

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About NPI 1699437822

Champ Moultrie's National Provider Identifier is 1699437822, issued on Oct 5, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Laurel, MD. The record was last updated on Oct 5, 2021.