Organization
SUPERBLOOM PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEREDITH WEST CRNP (PSYCHIATRIC NURSE PRACTITIONER)
(912) 596-7573
Entity
Organization
Contact information
Practice address
301 MAIN ST STE 2D, REISTERSTOWN, MD 21136-1957
(443) 203-8613
Mailing address
7 SAXONY CT, PIKESVILLE, MD 21208-3319
(912) 596-7573
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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