| Tarah Davidson Llc | |
|
19000 Forest Brook Road Germantown MD 20874 | |
| (240) 200-4050 | |
| Not Available |
| Full Name | Tarah Davidson Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 19000 Forest Brook Road, Germantown, Maryland |
| Authorized Official Name and Position | Tarah Davidson (OWNER) |
| Authorized Official Contact | 2402004050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarah Davidson Llc 12774 Wisteria Dr Unit 2954 Germantown MD 20875-7644 Ph: (240) 200-4050 | Tarah Davidson Llc 19000 Forest Brook Road Germantown MD 20874 Ph: (240) 200-4050 |
| NPI Number | 1699416669 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 04/05/2022 |
| Certification Date | 03/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699416669 | NPI | - | NPPES |
| 888386600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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