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Organization
REVITALIZING INNER SELF ESSENCE LLC
Active
Organization
REVITALIZING INNER SELF ESSENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA SIMMONS (OWNER)
(410) 929-6632
Entity
Organization
Contact information
Practice address
17 WARREN RD STE 3A, PIKESVILLE, MD 21208-5001
(410) 929-6632
Mailing address
PO BOX 1448, OWINGS MILLS, MD 21117-1403
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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