Individual
MRS. PHYLLIS TENNESSEE-NEWBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
3502 W ROGERS AVE, BALTIMORE, MD 21215-4749
(410) 318-8190
Mailing address
2845 BANEBERRY CT, BALTIMORE, MD 21209-3826
(410) 318-8190
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
18673
MD
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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