Organization
EASTERN SHORE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES RONNIE RUSSELL (CEO)
(410) 275-1961
Entity
Organization
Contact information
Practice address
1046 POND NECK RD, EARLEVILLE, MD 21919-2342
(410) 275-1961
Mailing address
1046 POND NECK RD, EARLEVILLE, MD 21919-2342
(410) 275-1961
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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