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Organization
TRANSFORMATION THERAPY CENTER INC
Active
Organization
TRANSFORMATION THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLIE I JAMISON MSW (LC SW-C)
(301) 856-6000
Entity
Organization
Contact information
Practice address
10401 HOSPITAL DR, SUITE G-03, CLINTON, MD 20735-3110
(301) 856-6000
(301) 856-8389
Mailing address
10401 HOSPITAL DR, SUITE G-03, CLINTON, MD 20735-3110
(301) 856-6000
(301) 856-8389
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
04071
MD
1041C0700X
Clinical Social Worker
Primary
10425
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10425
LICENSE
MD
Enumeration date
03/18/2010
Last updated
08/31/2010
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