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General NPI Number Information
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NPI Number | 1386982825
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Entity Type | Organization
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Legal Business Name | TREASURES IN CLAY SERVICES FOR CHILDREN AND FAMILIES
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 5104 MARLIN CT
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City | WALDORF
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State | MD
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Zip | 20603-4245
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Country | US
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Telephone | 301-536-2933
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Fax | 301-632-6616
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Provider Business Mailing Address
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Address Line | 5104 MARLIN CT
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City | WALDORF
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State | MD
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Zip | 20603-4245
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | CARLTON SUTTON
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Credential | PHD
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Telephone | 301-536-2933
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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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