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General NPI Number Information
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NPI Number | 1316613920
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Entity Type | Organization
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Legal Business Name | CHANNEL MARKER, INC.
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 8865 GLEBE PARK DR UNIT 3
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City | EASTON
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State | MD
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Zip | 21601-7069
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Country | US
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Telephone | 410-822-4611
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Fax |
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Provider Business Mailing Address
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Address Line | 8865 GLEBE PARK DR UNIT 1
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City | EASTON
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State | MD
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Zip | 21601-7069
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Country | US
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Telephone | 410-822-4619
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CATHERINE BARWICK CASSELL
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Credential | LCSW-C
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Telephone | 410-822-4619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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