| Devaughn Intervention Teach And Treat Options | |
|
1528 Country Ridge Ln Essex MD 21221-3906 | |
| (443) 271-8046 | |
| (410) 665-0400 |
| Full Name | Devaughn Intervention Teach And Treat Options |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1528 Country Ridge Ln, Essex, 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 1528 Country Ridge Ln Essex MD 21221-3906 Ph: (443) 271-8046 |
| NPI Number | 1093248577 |
|---|---|
| Provider Enumeration Date | 04/11/2017 |
| Last Update Date | 03/02/2021 |
| Certification Date | 03/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093248577 | NPI | - | NPPES |
| 570127900 | Medicaid | MD | |
| 570127901 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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