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General NPI Number Information
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NPI Number | 1558809251
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE THERAPY, LLC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 10551 METROPOLITAN AVE
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City | KENSINGTON
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State | MD
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Zip | 20895-2627
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Country | US
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Telephone | 301-452-4226
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 CARTER MILL WAY
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City | BROOKEVILLE
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State | MD
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Zip | 20833-3203
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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 | OWNER
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Name | BINILA ABRAHAM
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Credential |
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Telephone | 301-452-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 21250
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License Number State | MD
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