Organization
WILDERNESS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LOUIS ANDERSON JR. LCSW-C (THERAPIST)
(443) 905-6795
Entity
Organization
Contact information
Practice address
5900 YORK RD, BALTIMORE, MD 21212-3041
(443) 905-6795
Mailing address
539 POTOMAC RD, JOPPA, MD 21085-4825
(443) 905-6795
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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