Organization
INNOVATIVE THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY CROMARTIE LCPC (CEO)
(301) 604-4826
Entity
Organization
Contact information
Practice address
14440 CHERRY LANE CT, 208, LAUREL, MD 20707-4946
(301) 604-1458
(301) 604-1459
Mailing address
14440 CHERRY LANE CT, 208, LAUREL, MD 20707-4946
(301) 604-1458
(301) 604-1459
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420981800
—
MD
Enumeration date
04/19/2013
Last updated
04/19/2013
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