Organization
RENACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA LORETO MIRANDA BRAVO LCPC (PRESIDENT)
(410) 892-3711
Entity
Organization
Contact information
Practice address
2200 TUCKER LN APT B3, GWYNN OAK, MD 21207-7835
(410) 892-3711
(855) 541-3197
Mailing address
2200 TUCKER LN APT B3, GWYNN OAK, MD 21207-7835
(410) 892-3711
(855) 541-3197
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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