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Organization
RIVERS OF HEALING LLC
Active
Organization
RIVERS OF HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA WAGNER LICSW, LCSW-I, MSW (OWNER)
(443) 449-8683
Entity
Organization
Contact information
Practice address
14502 GREENVIEW DR STE 500, LAUREL, MD 20708-4245
(301) 825-1982
Mailing address
14502 GREENVIEW DR STE 550, LAUREL, MD 20708-3287
(301) 825-1982
(443) 279-2793
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336432749
INDIVIDUAL NPI
MD
Enumeration date
12/28/2018
Last updated
08/12/2024
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