Organization
ACTIVELY AGING TO PERFECTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERISSA BROWN (MANAGER)
(443) 470-9998
Entity
Organization
Contact information
Practice address
4709 HARFORD ROAD, SUITE A, 2ND FL #11, BALTIMORE, MD 21214-3261
(410) 648-9707
Mailing address
4709 HARFORD ROAD, SUITE A, 2ND FL #11, BALTIMORE, MD 21214-3261
(410) 648-9707
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/03/2020
Last updated
12/06/2020
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