Organization
A NEW LEAF THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE IRENE NYBLADE LCSW-C (OWNER)
(202) 487-8450
Entity
Organization
Contact information
Practice address
2911 OLNEY SANDY SPRING RD STE A, OLNEY, MD 20832-3506
(202) 487-8450
(443) 692-2170
Mailing address
6597 QUIET HOURS, APARTMENT 202, COLUMBIA, MD 21045-4943
(202) 487-8450
(443) 692-2170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13961
MD
1041C0700X
Clinical Social Worker
18412
MD
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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