Healthcare Provider Details

I. General information

NPI: 1659885457
Provider Name (Legal Business Name): C.H.O.I.C.E.S. INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 APOLLO DR STE 304
UPPER MARLBORO MD
20774-4790
US

IV. Provider business mailing address

PO BOX 402
UPPER MARLBORO MD
20773-0402
US

V. Phone/Fax

Practice location:
  • Phone: 240-389-4685
  • Fax:
Mailing address:
  • Phone: 240-389-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LACONYA L REED
Title or Position: CEO
Credential: LCPC, LPC, MAC, CAC
Phone: 240-389-4685