Healthcare Provider Details
I. General information
NPI: 1558754101
Provider Name (Legal Business Name): NEW NORMAL COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2015
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1331 ASHTON RD
HANOVER MD
21076-3157
US
IV. Provider business mailing address
7516 SAFFRON CT
HANOVER MD
21076-1459
US
V. Phone/Fax
- Phone: 443-597-2363
- Fax:
- Phone: 443-597-2363
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | LC2706 |
| License Number State | MD |
VIII. Authorized Official
Name:
ANNETTE
M
HYMAN
Title or Position: EXECUTIVE DIRECTOR, FOUNDER
Credential:
Phone: 443-597-2364