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1912693011
KELLY KOONTZ THOMPSON
COLUMBIA, MD
NPI
1912693011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MD LC3532)
Enumeration Date
2023-04-12
Last Update Date
2023-04-12
Business Address
KELLY KOONTZ THOMPSON
5570 STERRETT PL
COLUMBIA, MD 21044-2641
Phone number: 410-730-0552
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Mailing Address
KELLY KOONTZ THOMPSON
5570 STERRETT PL
COLUMBIA, MD 21044-2641
Phone number:
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