Live.balanced.life.llc | |
5305 Village Center Dr Ste 176 Columbia MD 21044-2382 | |
(240) 705-3086 | |
Not Available |
Full Name | Live.balanced.life.llc |
---|---|
Speciality | Counselor |
Location | 5305 Village Center Dr Ste 176, Columbia, Maryland |
Authorized Official Name and Position | Christine Nadine Williams (OWNER/PSYCHOTHERAPIST) |
Authorized Official Contact | 2407053086 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Live.balanced.life.llc 5305 Village Center Dr Ste 176 Columbia MD 21044-2382 Ph: (240) 705-3086 | Live.balanced.life.llc 5305 Village Center Dr Ste 176 Columbia MD 21044-2382 Ph: (240) 705-3086 |
NPI Number | 1811483761 |
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Provider Enumeration Date | 07/03/2018 |
Last Update Date | 07/03/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811483761 | NPI | - | NPPES |
989010600 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | LC6864 (Maryland) | Primary |
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