Organization
INTENTIONAL HEALING SPACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY P DARDEN (OWNER)
(410) 733-2055
Entity
Organization
Contact information
Practice address
8517 GREENS LN, WINDSOR MILL, MD 21244-1124
(410) 733-2055
Mailing address
8517 GREENS LN, WINDSOR MILL, MD 21244-1124
(410) 733-2055
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14857
MD
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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