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General NPI Number Information
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NPI Number | 1578630083
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Entity Type | Organization
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Legal Business Name | TRADITIONAL AND SPIRITUAL COUNSELING INC.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 2702 ALLENDALE RD
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City | BALTIMORE
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State | MD
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Zip | 21216-2133
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Country | US
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Telephone | 410-664-4758
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Fax | 410-664-9399
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Provider Business Mailing Address
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Address Line | 2702 ALLENDALE RD
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City | BALTIMORE
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State | MD
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Zip | 21216-2133
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Country | US
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Telephone | 410-664-4758
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Fax | 410-664-9399
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. OMIRA LEE
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Credential | LCSW-C
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Telephone | 410-664-4758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 07228
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License Number State | MD
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