Organization
MINDBRIDGE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVE EMLYN THATCHER JR. (OWNER)
(443) 930-0785
Entity
Organization
Contact information
Practice address
4624 RIDDLE DR, BALTIMORE, MD 21236-5703
(443) 930-0785
Mailing address
4624 RIDDLE DR, BALTIMORE, MD 21236-5703
(443) 930-0785
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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