Organization
INNOVATIVE STATE OF MIND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA M HUFFINES LCSW-C (SOLE OWNER)
(240) 486-0694
Entity
Organization
Contact information
Practice address
116 BAPTIST ST, SALISBURY, MD 21801-4911
(240) 486-0694
Mailing address
1147 S SALISBURY BLVD STE 8, #274, SALISBURY, MD 21801-6865
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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