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Organization

PURE POTENTIAL UNLIMITED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MELODYE L WATSON LCSW-C (BEHAVIORAL HEALTH THERAPIST)
(301) 910-1976
Entity
Organization

Contact information

Practice address
2712 PELHAM AVE, BALTIMORE, MD 21213-1119
(301) 910-1976
Mailing address
2712 PELHAM AVE, BALTIMORE, MD 21213-1119
(301) 910-1976

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
19349
MD

Other

Enumeration date
11/09/2013
Last updated
11/09/2013
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