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General NPI Number Information
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NPI Number | 1366740078
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Entity Type | Organization
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Legal Business Name | S BARBARA PERRY LLC
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 25 W CHESAPEAKE AVE
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City | TOWSON
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State | MD
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Zip | 21204-4820
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Country | US
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Telephone | 410-984-3362
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Fax | 410-339-3475
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Provider Business Mailing Address
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Address Line | 25 W CHESAPEAKE AVE
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City | TOWSON
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State | MD
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Zip | 21204-4820
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Country | US
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Telephone | 410-984-3362
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Fax | 410-339-3475
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Authorized Official
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Title or Position | LCSW-C
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Name | MS. STEPHANIE BARBARA PERRY
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Credential | MSW
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Telephone | 410-984-3362
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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 | 07087
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License Number State | MD
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