| The Metamorphorsis Institute, Llc | |
|
7131 Liberty Rd Suite 202 Baltimore MD 21207-4575 | |
| (443) 436-3003 | |
| (443) 436-3002 |
| Full Name | The Metamorphorsis Institute, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 7131 Liberty Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Mary L Taylor-ennis (PSYCHOLOGIST/MEMBER) |
| Authorized Official Contact | 4434445798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Metamorphorsis Institute, Llc 7131 Liberty Rd Suite 202 Baltimore MD 21207-4575 Ph: (443) 436-3003 | The Metamorphorsis Institute, Llc 7131 Liberty Rd Suite 202 Baltimore MD 21207-4575 Ph: (443) 436-3003 |
| NPI Number | 1609109131 |
|---|---|
| Provider Enumeration Date | 09/16/2009 |
| Last Update Date | 09/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609109131 | NPI | - | NPPES |
| 251502400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 03567 (Maryland) | Primary |
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