| The Holding Space Group | |
|
2908 Fleetwood Ave Baltimore MD 21214-1207 | |
| (717) 330-4202 | |
| Not Available |
| Full Name | The Holding Space Group |
|---|---|
| Speciality | Social Worker |
| Location | 2908 Fleetwood Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Mwuese Igyor (SOCIAL WORKER) |
| Authorized Official Contact | 7173304202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Holding Space Group 2908 Fleetwood Ave Baltimore MD 21214-1207 Ph: (717) 330-4202 | The Holding Space Group 2908 Fleetwood Ave Baltimore MD 21214-1207 Ph: (717) 330-4202 |
| NPI Number | 1336802016 |
|---|---|
| Provider Enumeration Date | 10/19/2021 |
| Last Update Date | 10/19/2021 |
| Certification Date | 10/19/2021 |
| Medicare PECOS PAC ID | 0547646606 |
|---|---|
| Medicare Enrollment ID | O20220928000388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336802016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mwuese Igyor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003353798 PECOS PAC ID: 1456737519 Enrollment ID: I20220928001113 |
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