| Shadow Work Therapeutics, Llc | |
|
19408 Gunpowder Rd Manchester MD 21102-2606 | |
| (443) 627-1687 | |
| Not Available |
| Full Name | Shadow Work Therapeutics, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 19408 Gunpowder Rd, Manchester, Maryland |
| Authorized Official Name and Position | Mika Uematsu (OWNER) |
| Authorized Official Contact | 4436271687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadow Work Therapeutics, Llc 19408 Gunpowder Rd Manchester MD 21102-2606 Ph: (443) 627-1687 | Shadow Work Therapeutics, Llc 19408 Gunpowder Rd Manchester MD 21102-2606 Ph: (443) 627-1687 |
| NPI Number | 1194507202 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 10/16/2023 |
| Certification Date | 10/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194507202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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