| Mergence, Inc | |
|
5209 York Rd Suite 15 Baltimore MD 21212-4225 | |
| (301) 769-6402 | |
| Not Available |
| Full Name | Mergence, Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5209 York Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Tiesha Mia Cohen (CO-FOUNDER/CLINICAL CONSULTANT) |
| Authorized Official Contact | 3017696402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mergence, Inc 5209 York Rd B-10 Baltimore MD 21212-4225 Ph: (301) 769-6402 | Mergence, Inc 5209 York Rd Suite 15 Baltimore MD 21212-4225 Ph: (301) 769-6402 |
| NPI Number | 1275927683 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 06/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275927683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC6047 (Maryland) | Primary |
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