Most Relevant Information
Provider Data
| NPI Number: | 1003298845 |
| Provider Name: | LARA JAYNE PETER LCPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | LC6145 |
Most Important Dates
| Enumeration Date: | 06/28/2015 |
| Last Updated: | 08/19/2021 |
Provider Practice Location
10630 LITTLE PATUXENT PKWY STE 209
COLUMBIA
MD
210446278
Practice Location Phone/Fax
| Phone: | 2404700663 |
| Fax: |
Provider Mailing Location
11905 NEW COUNTRY LN
COLUMBIA
MD
210444404
Provider Mailing Phone/Fax
| Phone: | 2404700663 |
| Fax: |