| Rbg Wellness Space, Llc | |
|
1206 Lakeside Ave Baltimore MD 21218-3001 | |
| (847) 770-7477 | |
| Not Available |
| Full Name | Rbg Wellness Space, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1206 Lakeside Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Aisha Jean-baptiste (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8477707477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rbg Wellness Space, Llc 1206 Lakeside Ave Baltimore MD 21218-3001 Ph: (847) 770-7477 | Rbg Wellness Space, Llc 1206 Lakeside Ave Baltimore MD 21218-3001 Ph: (847) 770-7477 |
| NPI Number | 1023609179 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 04/05/2021 |
| Certification Date | 04/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023609179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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