# CPESN MARYLAND, INC

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

## Provider details

- **NPI number:** 1588422588
- **Authorized official:** DEANNA LEIKACH RPH (MANAGING NETWORK FACILITATOR)
- **Authorized official phone:** (443) 386-1062

## Contact information

- **Practice address:** 6350 FREDERICK RD, BALTIMORE, MD 21228-2375
- **Practice address phone:** (410) 744-5959
- **Practice address fax:** (410) 744-4810
- **Mailing address:** 10821 RED RUN BLVD UNIT 1795, OWINGS MILLS, MD 21117-8581
- **Mailing address phone:** (443) 386-1062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2024
- **Last updated:** 03/20/2024