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Organization
RELEASE AND RENEW MENTAL WELLNESS CLINIC
Active
Organization
RELEASE AND RENEW MENTAL WELLNESS CLINIC
Active
Other names
Release and Renew Mental Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA POTTILLO APRN-PMH (OWNER)
(443) 745-8620
Entity
Organization
Contact information
Practice address
1301 YORK RD STE 800, LUTHERVILLE TIMONIUM, MD 21093-6011
(410) 376-8728
(410) 862-3774
Mailing address
1301 YORK RD STE 800, LUTHERVILLE TIMONIUM, MD 21093-6011
(410) 376-8728
(410) 862-3774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
07/19/2024
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