Healthcare Provider Details

I. General information

NPI: 1124576780
Provider Name (Legal Business Name): KARINA ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 JENIFER RD
TIMONIUM MD
21093-7473
US

IV. Provider business mailing address

11911 JENIFER RD
TIMONIUM MD
21093-7473
US

V. Phone/Fax

Practice location:
  • Phone: 443-928-0542
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. BILIANA BORIMETCHKOVA
Title or Position: CEO
Credential:
Phone: 443-928-0542