Healthcare Provider Details

I. General information

NPI: 1326959826
Provider Name (Legal Business Name): RHEA ISABELLA SANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CLIPPER MILL RD STE 212
BALTIMORE MD
21211-1955
US

IV. Provider business mailing address

9304 GEORGIA BELLE DR BSMT
PERRY HALL MD
21128-8816
US

V. Phone/Fax

Practice location:
  • Phone: 410-497-8451
  • Fax:
Mailing address:
  • Phone: 443-630-0631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18502
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: