Healthcare Provider Details

I. General information

NPI: 1346790466
Provider Name (Legal Business Name): EMPATHKARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 SMITH AVE
BALTIMORE MD
21209-2634
US

IV. Provider business mailing address

2408 SMITH AVE
BALTIMORE MD
21209-2634
US

V. Phone/Fax

Practice location:
  • Phone: 443-768-6095
  • Fax:
Mailing address:
  • Phone: 443-768-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: GRACE EKPENYONG
Title or Position: ADMINISTRATOR
Credential:
Phone: 443-768-6095