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General NPI Number Information
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NPI Number | 1720786460
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Entity Type | Organization
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Legal Business Name | ACKNOWLEDGE, RESTORE, AND GROW LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 22776 THREE NOTCH RD STE 209
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-3370
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Country | US
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Telephone | 301-882-5150
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Fax | 301-664-2288
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Provider Business Mailing Address
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Address Line | 22650 CEDAR LANE CT # 148
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City | LEONARDTOWN
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State | MD
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Zip | 20650-4227
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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 | HEIDI ANN MARLATT
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Credential | LCMFT
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Telephone | 719-291-9592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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