Organization
WOODBOURNE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY WILSON (EXECUTIVE DIRECTOR)
(410) 433-1000
Entity
Organization
Contact information
Practice address
1301 WOODBOURNE AVE, BALTIMORE, MD 21239-3316
(410) 433-1000
(410) 433-1459
Mailing address
1301 WOODBOURNE AVE, BALTIMORE, MD 21239-3316
(410) 433-1000
(410) 433-1459
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
30-073
MD
1041S0200X
School Social Worker
Primary
—
—
163WS0200X
School Registered Nurse
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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