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General NPI Number Information
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NPI Number | 1942533773
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Entity Type | Organization
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Legal Business Name | BARSTOW ACRES CHILDREN CENTER
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 590 MAIN ST
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3346
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Country | US
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Telephone | 410-414-9901
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Fax | 410-414-9902
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Provider Business Mailing Address
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Address Line | 590 MAIN ST
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3346
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Country | US
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Telephone | 410-414-9901
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Fax | 410-414-9902
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Authorized Official
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Title or Position | DIRECTOR
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Name | SONIA DELICIA HINDS
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Credential | APRN-BC
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Telephone | 410-414-9901
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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 | R071676
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License Number State | MD
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