| Devaughn Intervention Teach And Treat Options | |
|
4804 York Rd Ste 2 Baltimore MD 21212-4401 | |
| (443) 271-8046 | |
| (443) 873-8958 |
| Full Name | Devaughn Intervention Teach And Treat Options |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4804 York Rd Ste 2, Baltimore, Maryland |
| Authorized Official Name and Position | Eva Devaughn (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4432718046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Devaughn Intervention Teach And Treat Options 5003 Ardmore Way Baltimore MD 21206-5004 Ph: (443) 271-8046 | Devaughn Intervention Teach And Treat Options 4804 York Rd Ste 2 Baltimore MD 21212-4401 Ph: (443) 271-8046 |
| NPI Number | 1831622315 |
|---|---|
| Provider Enumeration Date | 04/11/2017 |
| Last Update Date | 12/23/2019 |
| Certification Date | 12/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831622315 | NPI | - | NPPES |
| 570127901 | Medicaid | MD | |
| 570127900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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