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Organization
REACHING YOUR DESTINY WELLNESS CENTER LLC
Active
Organization
REACHING YOUR DESTINY WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELISA PROCKS (PHD)
(410) 999-9999
Entity
Organization
Contact information
Practice address
4327 HARFORD RD STE 2, BALTIMORE, MD 21214-3184
(410) 999-9999
Mailing address
2206 WESTFIELD AVE, BALTIMORE, MD 21214-1050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
163WC0400X
Case Management Registered Nurse
—
NULL
163WC0400X
Case Management Registered Nurse
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
374J00000X
Doula
—
NULL
374J00000X
Doula
—
—
Other
Enumeration date
01/25/2024
Last updated
10/23/2024
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