Organization
BASICS THROUGH GROUP PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO LAGRANGE PH.D. (COO/VP)
(301) 420-1972
Entity
Organization
Contact information
Practice address
11228 KETTERING PLACE, UPPER MARLBORO, MD 20774-1575
(202) 427-2125
Mailing address
11228 KETTERING PL, UPPER MARLBORO, MD 20774-1575
(202) 427-2125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50078424
DC
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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