Organization
REACHING YOUR DESTINY WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELISA PROCKS (PHD)
(410) 999-9999
Entity
Organization
Contact information
Practice address
4327 HARFORD RD STE 2, BALTIMORE, MD 21214-3184
(410) 999-9999
Mailing address
2206 WESTFIELD AVE, BALTIMORE, MD 21214-1050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163WC0400X
Case Management Registered Nurse
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
374J00000X
Doula
—
—
Other
Enumeration date
01/25/2024
Last updated
10/23/2024
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