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General NPI Number Information
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NPI Number | 1285494005
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Entity Type | Organization
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Legal Business Name | EAST COAST COGNITIVE BEHAVIORAL THERAPY
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 6452 KNIGHT DR
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City | ELDERSBURG
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State | MD
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Zip | 21784-6744
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Country | US
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Telephone | 443-293-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 6452 KNIGHT DR
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City | ELDERSBURG
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State | MD
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Zip | 21784-6744
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Country | US
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Telephone | 443-293-6611
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN SCHLUTER
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Credential | PSYD
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Telephone | 443-293-6611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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