# MIND OVER MATTER HEALTH SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558889857
- **Authorized official:** ASIA MARIA JOHNSON LCPC,ACS,LCAD-AS,MAC (CEO)
- **Authorized official phone:** (410) 982-1353

## Contact information

- **Practice address:** 616 OLD EDMONDSON AVE. STE. 4, BALTIMORE, MD 21228
- **Practice address phone:** (443) 405-1095
- **Mailing address:** 616 OLD EDMONDSON AVE. STE. 4, BALTO, MD 21228
- **Mailing address phone:** (443) 405-1095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251S0007X | Sports Physical Therapist | LC2133 | MD | Yes |

## Other

- **Enumeration date:** 09/07/2017
- **Last updated:** 09/07/2017