Individual
CELSIUS NDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4660 MARTIN LUTHER KING JR AVE SW STE A2, WASHINGTON, DC 20032-4933
(202) 318-0179
Mailing address
11737 ELLINGTON DR, BELTSVILLE, MD 20705-1308
(240) 429-5740
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
07/05/2023
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