Organization
INTEGRATIVE THERAPY CENTER OF MARYLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSHE MILLER PSYD (OWNER)
(414) 213-9636
Entity
Organization
Contact information
Practice address
1501 SULGRAVE AVE STE 205, BALTIMORE, MD 21209-3650
(414) 213-9636
Mailing address
2810 HANSON AVE, BALTIMORE, MD 21209-3912
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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