Healthcare Provider Details

I. General information

NPI: 1134858319
Provider Name (Legal Business Name): IRIS ARRINGTON CAC-AD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 REISTERSTOWN RD # 150
BALTIMORE MD
21215-7601
US

IV. Provider business mailing address

2330 OCALA AVE
BALTIMORE MD
21215-7802
US

V. Phone/Fax

Practice location:
  • Phone: 410-367-7821
  • Fax:
Mailing address:
  • Phone: 410-585-4624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: