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General NPI Number Information
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NPI Number | 1033002050
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Entity Type | Organization
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Legal Business Name | DXT THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 7610 PENNSYLVANIA AVE STE 301
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City | FORESTVILLE
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State | MD
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Zip | 20747-4764
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Country | US
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Telephone | 240-838-3707
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Fax | 240-470-1223
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Provider Business Mailing Address
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Address Line | 7610 PENNSYLVANIA AVE STE 301
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City | FORESTVILLE
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State | MD
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Zip | 20747-4764
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Country | US
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Telephone | 240-838-3707
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Fax | 240-470-1223
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Authorized Official
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Title or Position | CLINICAL ALCOHOL AND DRUG SUPERVISO
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Name | MICHELLE F HARE
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Credential | LGADC, CAC, CSC, TRA
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Telephone | 240-676-2895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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