| Gustavo Nicolas Diaz Revelo, | |
|
100 Owings Ct, Suite 8, Reisterstown, MD 21136-6428 | |
| (410) 526-7100 | |
| Not Available |
| Full Name | Gustavo Nicolas Diaz Revelo |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 100 Owings Ct, Reisterstown, Maryland |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568887537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Maryland) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo Nicolas Diaz Revelo, 301 Dumbarton Rd, Baltimore, MD 21212-1533 Ph: (443) 791-8384 | Gustavo Nicolas Diaz Revelo, 100 Owings Ct, Suite 8, Reisterstown, MD 21136-6428 Ph: (410) 526-7100 |
Ilana Meiller, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 37 Main St, Reisterstown, MD 21136 Phone: 410-526-7882 | |
Leah Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Owings Ct Ste 5, Reisterstown, MD 21136 Phone: 443-610-4425 | |
Doreen Scott, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Owings Ct, Suite 8, Reisterstown, MD 21136 Phone: 410-526-7100 | |
Tracy Brenton, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14450 Hanover Pike, Reisterstown, MD 21136 Phone: 410-569-9497 Fax: 410-569-0094 | |
Joshua Mandell, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 37 Main St, Reisterstown, MD 21136 Phone: 410-812-5623 | |
Mrs. Marsha Ann Swilley, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 520 Education Way, Reisterstown, MD 21136 Phone: 410-526-4888 | |
Erica K. Matthews Malaka, PSYD Counselor Medicare: Not Enrolled in Medicare Practice Location: 12039 Reisterstown Rd, Reisterstown, MD 21136 Phone: 410-526-5000 |