| Revitalizing Inner Self Essence Llc | |
|
17 Warren Rd Ste 3a Pikesville MD 21208-5001 | |
| (410) 929-6632 | |
| Not Available |
| Full Name | Revitalizing Inner Self Essence Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 17 Warren Rd Ste 3a, Pikesville, Maryland |
| Authorized Official Name and Position | Christina Simmons (OWNER) |
| Authorized Official Contact | 4109296632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalizing Inner Self Essence Llc Po Box 1448 Owings Mills MD 21117-1403 Ph: () - | Revitalizing Inner Self Essence Llc 17 Warren Rd Ste 3a Pikesville MD 21208-5001 Ph: (410) 929-6632 |
| NPI Number | 1114682960 |
|---|---|
| Provider Enumeration Date | 11/07/2021 |
| Last Update Date | 11/07/2021 |
| Certification Date | 11/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114682960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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