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General NPI Number Information
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NPI Number | 1568044980
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Entity Type | Organization
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Legal Business Name | THERAHUB LLC
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 18427 CORNFLOWER RD
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City | BOYDS
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State | MD
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Zip | 20841-4337
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Country | US
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Telephone | 301-704-1692
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Fax |
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Provider Business Mailing Address
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Address Line | 18427 CORNFLOWER RD
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City | BOYDS
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State | MD
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Zip | 20841-4337
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Country | US
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Telephone | 301-704-1692
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JULIANE SCHOENHERR
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Credential |
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Telephone | 240-608-0628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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