| Wye Oak Therapeutic Services, Llc | |
|
165 Log Canoe Cir Ste B-3 Stevensville MD 21666-2149 | |
| (443) 249-3351 | |
| Not Available |
| Full Name | Wye Oak Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 165 Log Canoe Cir Ste B-3, Stevensville, Maryland |
| Authorized Official Name and Position | Crystal R Blanchard (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 4432492601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wye Oak Therapeutic Services, Llc 165 Log Canoe Cir Ste B-3 Stevensville MD 21666-2149 Ph: (443) 249-3351 | Wye Oak Therapeutic Services, Llc 165 Log Canoe Cir Ste B-3 Stevensville MD 21666-2149 Ph: (443) 249-3351 |
| NPI Number | 1063073450 |
|---|---|
| Provider Enumeration Date | 06/26/2019 |
| Last Update Date | 04/03/2023 |
| Certification Date | 04/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063073450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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