| Innergy Renewal, Llc | |
|
11317 Kettering Cir Upper Marlboro MD 20774-1675 | |
| (301) 364-8913 | |
| Not Available |
| Full Name | Innergy Renewal, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 11317 Kettering Cir, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Lia Jones (OWNER) |
| Authorized Official Contact | 3019174210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innergy Renewal, Llc 11317 Kettering Cir Upper Marlboro MD 20774-1675 Ph: (301) 364-8913 | Innergy Renewal, Llc 11317 Kettering Cir Upper Marlboro MD 20774-1675 Ph: (301) 364-8913 |
| NPI Number | 1053071324 |
|---|---|
| Provider Enumeration Date | 12/28/2021 |
| Last Update Date | 12/28/2021 |
| Certification Date | 12/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053071324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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