Organization
CANTON CHILD AND FAMILY THERAPY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAMSI C TUMMALACHETTY PSYD (FOUNDER/LEAD PSYCHOLOGIST)
(443) 300-8255
Entity
Organization
Contact information
Practice address
2700 LIGHTHOUSE PT E STE 270, BALTIMORE, MD 21224-4791
(443) 589-5848
Mailing address
2700 LIGHTHOUSE PT E STE 270, BALTIMORE, MD 21224-4791
(443) 300-8255
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
09/23/2021
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