Provider Demographics
NPI:1750653879
Name:ARNOLD, DAVIDA I (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:DAVIDA
Middle Name:I
Last Name:ARNOLD
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 1:5407 ROLAND AVE APT B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1991
Mailing Address - Country:US
Mailing Address - Phone:410-635-4673
Mailing Address - Fax:
Practice Address - Street 1:600 WYNDHURST AVE
Practice Address - Street 2:SUITE 307C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2489
Practice Address - Country:US
Practice Address - Phone:410-635-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-05
Last Update Date:2012-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP3385101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional