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General NPI Number Information
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NPI Number | 1720788128
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Entity Type | Organization
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Legal Business Name | NEW LEAF TELETHERAPY LLC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 1829 REISTERSTOWN RD STE 350
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City | PIKESVILLE
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State | MD
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Zip | 21208-7126
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Country | US
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Telephone | 240-358-1379
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Fax |
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Provider Business Mailing Address
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Address Line | 1829 REISTERSTOWN RD STE 350
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City | PIKESVILLE
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State | MD
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Zip | 21208-7126
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Country | US
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Telephone | 240-358-1379
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER & MANAGING DIRECTOR
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Name | MRS. DEBORAH HILSE ROMANO
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Credential |
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Telephone | 240-358-1379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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