Organization
SUNRISE THERAPEUTIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA YVETTE ROGERS LCPC (CEO)
(240) 383-6343
Entity
Organization
Contact information
Practice address
10111 MARTIN LUTHER KING JR HWY, SUITE 103, BOWIE, MD 20720-4200
(240) 383-6343
Mailing address
10111 MARTIN LUTHER KING JR HWY, SUITE 103, BOWIE, MD 20720-4200
(240) 383-6343
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC5754
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214237600
—
MD
Enumeration date
09/13/2016
Last updated
09/13/2016
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