Organization
GENNESARET COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOYIN OPESANMI MD (CEO)
(410) 528-6003
Entity
Organization
Contact information
Practice address
1100 W PRATT ST, BALTIMORE, MD 21223-2689
(410) 528-6003
(410) 528-6004
Mailing address
12108 EARLY LILACS PATH, CLARKSVILLE, MD 21029-1676
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
08986
MD
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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