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General NPI Number Information
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NPI Number | 1902379696
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Entity Type | Organization
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Legal Business Name | UNLOCKING RESILIENCE, LLC
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Dates
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Enumeration Date | 01/06/2019
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Last Update Date | 01/06/2019
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Provider Practice Location Address
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Address Line | 22 N MULBERRY ST STE 14&120
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City | HAGERSTOWN
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State | MD
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Zip | 21740-4870
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Country | US
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Telephone | 240-986-3139
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Fax | 301-576-3828
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Provider Business Mailing Address
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Address Line | 1 SAHALEE CT
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City | MARTINSBURG
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State | WV
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Zip | 25403-7307
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Country | US
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Telephone | 304-616-2396
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Fax |
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Authorized Official
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Title or Position | CHILD AND FAMILY THERAPIST
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Name | MS. JENNIFER LEE CANBY
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Credential | MSW, LCSW-C
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Telephone | 240-986-3139
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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 |
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License Number State |
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