Individual
DENISE SUPIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 WYNDHURST AVE STE 308, BALTIMORE, MD 21210-2415
(443) 310-8214
Mailing address
600 WYNDHURST AVE STE 308, BALTIMORE, MD 21210-2415
(443) 310-8214
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1280
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45-5476114
TAX ID
MD
Enumeration date
03/13/2014
Last updated
03/13/2014
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