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Organization
RESTORATIVE LIFE THERAPY SERVICES, LLC
Active
Organization
RESTORATIVE LIFE THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANISHA R BARNES LICSW, LCSW-C (CLINICAL SOCIAL WORKER)
(443) 743-2563
Entity
Organization
Contact information
Practice address
2908 MUESERBUSH CT, GLENARDEN, MD 20706-5514
(443) 743-2563
Mailing address
10530 CAMPUS WAY S # 1118, LARGO, MD 20774-1309
(443) 743-2563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
734503800
—
MD
Enumeration date
10/18/2021
Last updated
10/28/2021
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