Organization
CAPITAL THERAPEUTIC SERVICES, LLCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LARHONDA S GOUGH LCSW-C, LICSW (CLINICAL MANAGER/CEO)
(240) 432-4030
Entity
Organization
Contact information
Practice address
2204 E MARLBORO AVE, HYATTSVILLE, MD 20785-5205
(240) 432-4030
Mailing address
2204 E MARLBORO AVE, HYATTSVILLE, MD 20785-5205
(240) 432-4030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13108
MD
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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