Organization
PSYCHOTHERAPEUTIC TREATMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL COOPER CFO (CHIEF FINANCIAL OFFICER)
(410) 778-9114
Entity
Organization
Contact information
Practice address
2021 RESEARCH DR, ANNAPOLIS, MD 21401-3038
(410) 224-1188
(410) 224-3711
Mailing address
820 HIGH STREET, SUITE 2, CHESTERTOWN, MD 21620-3909
(410) 778-9114
(410) 778-7988
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
08/22/2020
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