Provider Demographics
NPI:1568161339
Name:LAY, PERLA MARIA (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:MARIA
Last Name:LAY
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 1:4402 IVES ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3253
Mailing Address - Country:US
Mailing Address - Phone:240-505-9311
Mailing Address - Fax:
Practice Address - Street 1:4402 IVES ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3253
Practice Address - Country:US
Practice Address - Phone:240-505-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health