Ima Therapy Center Llc | |
3355 Saint Johns Ln Ste F Ellicott City MD 21042-2600 | |
(410) 324-3883 | |
Not Available |
Full Name | Ima Therapy Center Llc |
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Speciality | Psychologist |
Location | 3355 Saint Johns Ln Ste F, Ellicott City, Maryland |
Authorized Official Name and Position | Mary-jane Ojie-badger (OWNER) |
Authorized Official Contact | 4103243883 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ima Therapy Center Llc 3355 Saint Johns Ln Ste F Ellicott City MD 21042-2600 Ph: (410) 324-3883 | Ima Therapy Center Llc 3355 Saint Johns Ln Ste F Ellicott City MD 21042-2600 Ph: (410) 324-3883 |
NPI Number | 1740056035 |
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Provider Enumeration Date | 11/28/2023 |
Last Update Date | 12/05/2023 |
Certification Date | 12/05/2023 |
Medicare PECOS PAC ID | 0749631067 |
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Medicare Enrollment ID | O20240110003971 |
Identifier | Type | State | Issuer |
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1740056035 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Mary Jane E Ojie Badger |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1104133081 PECOS PAC ID: 3173825874 Enrollment ID: I20181017002302 |
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