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Organization
FULL POTENTIAL DMV
Active
Organization
FULL POTENTIAL DMV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE ANTOINETTA MCCRAY (CASE MANAGER)
(202) 246-1062
Entity
Organization
Contact information
Practice address
220 S FULTON AVE, BALTIMORE, MD 21223-3005
(202) 246-1062
Mailing address
220 S FULTON AVE, BALTIMORE, MD 21223-3005
(202) 246-1062
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
1041S0200X
School Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
163WS0200X
School Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
12/19/2023
Last updated
05/06/2024
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