Organization
SOUL-RENITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIER MICHELLE JOHNSON LCPC (PSYCHOTHERAPIST)
(410) 921-9800
Entity
Organization
Contact information
Practice address
1601 SAINT PAUL ST, 2ND FLOOR, BALTIMORE, MD 21202-4871
(410) 921-9800
(410) 928-4222
Mailing address
1601 SAINT PAUL ST, 2ND FLOOR, BALTIMORE, MD 21202-4871
(410) 921-9800
(410) 928-4222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2447
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304800400
—
MD
Enumeration date
05/29/2013
Last updated
05/08/2017
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