Sarah Bong Agboli, LCMFT

Individual provider Active NPI Marriage & Family Therapist · Columbia, MD

NPI 1578884201 · NPPES record last updated Jun 16, 2014

Key facts

NPI
1578884201
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LCM369 (MD)
Practice address
10630 Little Patuxent Pkwy
Suite 209
Columbia, MD 21044-3264
Phone
(410) 740-8069
NPI assigned
Jun 16, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCM369MDMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LCM369 MD Yes

Addresses

Primary practice location

10630 Little Patuxent Pkwy
Suite 209
Columbia, MD 21044-3264

Mailing address

10630 Little Patuxent Pkwy
Suite 209
Columbia, MD 21044-3264
Phone (410) 740-8069

Other providers in Columbia, MD

All providers in Columbia, MD · Marriage & Family Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.