Organization
R.E.A.L. THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLLE ROCHE WADDY LCPC (OWNER)
(202) 805-3376
Entity
Organization
Contact information
Practice address
6327 FOSTER ST, DISTRICT HEIGHTS, MD 20747-4929
(202) 805-3376
Mailing address
6327 FOSTER ST, DISTRICT HEIGHTS, MD 20747-4929
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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