Nautical Breeze Therapy, Llc | |
29626 Old Creek Ln Easton MD 21601-7929 | |
(301) 331-1664 | |
Not Available |
Full Name | Nautical Breeze Therapy, Llc |
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Speciality | Marriage & Family Therapist |
Location | 29626 Old Creek Ln, Easton, Maryland |
Authorized Official Name and Position | Shannon Holmes (LMFT) |
Authorized Official Contact | 3013311664 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nautical Breeze Therapy, Llc 29626 Old Creek Ln Easton MD 21601-7929 Ph: (301) 331-1664 | Nautical Breeze Therapy, Llc 29626 Old Creek Ln Easton MD 21601-7929 Ph: (301) 331-1664 |
NPI Number | 1861153926 |
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Provider Enumeration Date | 12/31/2021 |
Last Update Date | 12/10/2023 |
Certification Date | 12/10/2023 |
Medicare PECOS PAC ID | 0941643126 |
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Medicare Enrollment ID | O20240205001547 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861153926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Provider Name | Shannon O'brien Holmes |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1891271979 PECOS PAC ID: 2769825942 Enrollment ID: I20240205002345 |
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