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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