Basic Information
| Provider Information | |||||||||
| NPI: | 1841611795 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BADRAN | ||||||||
| FirstName: | LEENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13503 KILDARE HILLS TER | ||||||||
| Address2: | APT 403 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208744645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134842447 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9475 LOTTSFORD RD | ||||||||
| Address2: | STE 250 | ||||||||
| City: | LARGO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207745357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016366504 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2013 | ||||||||
| LastUpdateDate: | 12/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LGP5420 | MD | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.