Champ Moultrie
Champ Moultrie is a Professional Counselor in Laurel, Maryland. Licensed in Maryland. Registered with an NPI since 2021.
- Licensed in
- MD
- In the registry since
- 2021
Practice location Address checks out
9660 Iron Leaf TrlLaurel, MD 20723-5878
Phone: (443) 687-6827
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Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X · Licence LGP10255 (MD) |
|---|
Record details
| NPI number | 1699437822 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | October 5, 2021 |
| Last updated in NPPES | October 5, 2021 |
| Certification date | October 5, 2021 |
| Mailing address | 7914 Bentbough Rd, Severn, MD 21144-1077 |
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