Individual
OLYTHIA BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
Mailing address
3430 PARK HEIGHTS AVE, BALTIMORE, MD 21215-7841
(410) 900-4599
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT820
MD
Other
Enumeration date
08/13/2014
Last updated
08/13/2014
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