| Lineout Therapy Llc | |
|
30 Daria Ct Timonium MD 21093-3044 | |
| (443) 530-7079 | |
| Not Available |
| Full Name | Lineout Therapy Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 30 Daria Ct, Timonium, Maryland |
| Authorized Official Name and Position | Benjamin Bowman (LCPC) |
| Authorized Official Contact | 5137205431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lineout Therapy Llc 6438 Lehnert St Gwynn Oak MD 21207-5275 Ph: () - | Lineout Therapy Llc 30 Daria Ct Timonium MD 21093-3044 Ph: (443) 530-7079 |
| NPI Number | 1033842257 |
|---|---|
| Provider Enumeration Date | 07/05/2022 |
| Last Update Date | 07/05/2022 |
| Certification Date | 05/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033842257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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