Organization
INTERDYNAMICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASNEITH D MAYBERRY CAC (CERTIFIED ASSO ALCOHOL&DRUG COUNSEL)
(301) 306-4590
Entity
Organization
Contact information
Practice address
4601 FORBES BLVD, LANHAM, MD 20706-4807
(301) 306-4590
(301) 306-4591
Mailing address
4601 FORBES BLVD, LANHAM, MD 20706-4807
(301) 306-4590
(301) 306-4591
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC1766
MD
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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