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General NPI Number Information
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NPI Number | 1588010417
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Entity Type | Organization
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Legal Business Name | JOURNEY IN THE GARDEN INC
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 3350 WILKENS AVE SUITE 301
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City | BALTIMORE
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State | MD
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Zip | 21229-4600
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Country | US
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Telephone | 667-212-4608
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Fax | 667-212-4584
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Provider Business Mailing Address
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Address Line | 3350 WILKENS AVE SUITE 301
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City | BALTIMORE
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State | MD
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Zip | 21229-4600
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Country | US
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Telephone | 667-212-4608
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Fax | 667-212-4584
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Authorized Official
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Title or Position | DIRECTOR
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Name | CELESTE MARIA BLAND-GUARY
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Credential | LCSW-C
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Telephone | 667-212-4608
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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 | 20155
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License Number State | MD
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