Organization
THE AUTHENTIC CORNER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEJA' MOSES LCPC (CEO)
(410) 774-5120
Entity
Organization
Contact information
Practice address
1341 HILL BORN DR, HANOVER, MD 21076-1174
(410) 774-5120
Mailing address
1341 HILL BORN DR, HANOVER, MD 21076-1174
(443) 942-2843
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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