Organization
KIDDIE KOACH PRP LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PRICE (FOUNDER)
(443) 657-3345
Entity
Organization
Contact information
Practice address
9922 LIBERTY RD, RANDALLSTOWN, MD 21133-1804
(443) 657-3345
Mailing address
9922 LIBERTY RD, RANDALLSTOWN, MD 21133-1804
(443) 657-3345
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/27/2019
Last updated
11/12/2020
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