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General NPI Number Information
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NPI Number | 1164163747
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIVE HEALING AND WELLNESS
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 9505 REISTERSTOWN RD # 3NW
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4451
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Country | US
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Telephone | 443-940-5550
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Fax | 410-504-8244
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Provider Business Mailing Address
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Address Line | PO BOX 1047
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City | OWINGS MILLS
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State | MD
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Zip | 21117-1015
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Country | US
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Telephone | 443-929-2272
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE JEANETTE GREENE
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Credential | LCSW-C
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Telephone | 443-929-2272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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