Healthcare Provider Details

I. General information

NPI: 1891528717
Provider Name (Legal Business Name): REMEDY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 REFINING DR
BROOKLYN PARK MD
21225-3100
US

IV. Provider business mailing address

220 REFINING DR
BROOKLYN PARK MD
21225-3100
US

V. Phone/Fax

Practice location:
  • Phone: 240-380-6229
  • Fax:
Mailing address:
  • Phone: 762-930-1956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHAMONIQUE DIONA DRISKELL
Title or Position: LICENSED THERAPIST AND OWNER
Credential: LCPC
Phone: 762-930-1956