Individual
TIA HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
2225 N CHARLES ST, BALTIMORE, MD 21218-5778
(410) 366-4360
(410) 662-8547
Mailing address
2225 N CHARLES ST, BALTIMORE, MD 21218-5778
(410) 366-4360
(410) 662-8547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC2064
MD
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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