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Organization
TAKOMA THERAPY, LLC
Active
Organization
TAKOMA THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMONE JACOBS (OWNER)
(301) 802-5653
Entity
Organization
Contact information
Practice address
6930 CARROLL AVE STE 830, TAKOMA PARK, MD 20912-4461
(301) 802-5653
Mailing address
6930 CARROLL AVE STE 830, TAKOMA PARK, MD 20912-4461
(301) 802-5653
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
416691400
—
MD
Enumeration date
02/24/2018
Last updated
04/23/2018
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