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TRANSFORMATION THERAPEUTIC SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIFFANY JOHNSON (CEO)
(240) 441-3344
Entity
Organization

Contact information

Practice address
16703 GOVERNOR BRIDGE RD APT 203, BOWIE, MD 20716-3678
(240) 441-3344
Mailing address
16703 GOVERNOR BRIDGE RD APT 203, BOWIE, MD 20716-3678

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
08/01/2021
Last updated
08/01/2021
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