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General NPI Number Information
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NPI Number | 1851906614
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Entity Type | Organization
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Legal Business Name | PATH TO PEACE WELLNESS, LLC
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 77-81 E MAIN STREET SUITE 206
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City | WESTMINSTER
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State | MD
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Zip | 21157-2115
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Country | US
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Telephone | 443-377-1865
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Fax |
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Provider Business Mailing Address
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Address Line | 9 W RIDGELY RD STE 600
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City | LUTHERVILLE
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State | MD
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Zip | 21093-5134
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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 | EMMA M DAVIS
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Credential | LCPC
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Telephone | 443-377-1865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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