Organization
RENEWED BEHAVIIORAL HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A DAVIS LCPC (CEO)
(757) 589-7677
Entity
Organization
Contact information
Practice address
3914 21ST AVE, TEMPLE HILLS, MD 20748-4320
(757) 589-7677
Mailing address
3914 21ST AVE, TEMPLE HILLS, MD 20748-4320
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
LC5858
MD
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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