Provider Demographics
NPI:1427202514
Name:WUETHRICH, LAUREN ELIZABETH (LGPC)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:WUETHRICH
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20410 OBSERVATION DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4000
Mailing Address - Country:US
Mailing Address - Phone:301-588-8881
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR
Practice Address - Street 2:SUITE 108
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4000
Practice Address - Country:US
Practice Address - Phone:301-588-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-16
Last Update Date:2008-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP2941101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional