Organization
DIVINE TOUCH THERAPEUTIC COUNSELING AND MENTORING SERVICES,, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOLADALE WURAOLA ADEGOROYE M.A, LCPC (THERAPIST)
(240) 481-9962
Entity
Organization
Contact information
Practice address
768 DUVALL HWY, PASADENA, MD 21122-1620
(240) 481-9962
Mailing address
PO BOX 444, PASADENA, MD 21123-0444
(240) 481-9962
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115593800
—
MD
Enumeration date
02/18/2017
Last updated
02/18/2017
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