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General NPI Number Information
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NPI Number | 1659789154
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Entity Type | Organization
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Legal Business Name | MARYLAND DRIVER SERVICES, LLC
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 1157 REECE RD
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City | SEVERN
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State | MD
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Zip | 21144-2423
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Country | US
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Telephone | 410-777-3656
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Fax | 410-555-1150
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Provider Business Mailing Address
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Address Line | 1157 REECE RD
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City | SEVERN
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State | MD
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Zip | 21144-2423
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Country | US
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Telephone | 410-777-3656
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Fax | 410-555-1150
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. CASEY MARY MCCALL
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Credential |
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Telephone | 410-777-3656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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