Individual
TAKEISHA BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3200 EASTERN AVE, BALTIMORE, MD 21224-4010
(443) 783-9366
Mailing address
2712 GRESHAM WAY UNIT 201, WINDSOR MILL, MD 21244-3957
(443) 783-9366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MD
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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