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General NPI Number Information
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NPI Number | 1104233188
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Entity Type | Organization
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Legal Business Name | NALTY & ASSOCIATES INC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 3425 SINCLAIR LN
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City | BALTIMORE
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State | MD
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Zip | 21213-2030
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Country | US
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Telephone | 410-366-1151
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Fax | 410-366-0032
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Provider Business Mailing Address
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Address Line | 3425 SINCLAIR LN
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City | BALTIMORE
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State | MD
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Zip | 21213-2030
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Country | US
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Telephone | 410-366-1151
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Fax | 410-366-0032
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Authorized Official
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Title or Position | CEO
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Name | CHARMAINE NALTY
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Credential | LCSW-C
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Telephone | 410-366-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 905160
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License Number State | MD
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