Provider First Line Business Practice Location Address:
300 REISTERSTOWN RD SUITE # 101
Provider Second Line Business Practice Location Address:
C/O TREE OF LIFE COUNSELING, LLC
Provider Business Practice Location Address City Name:
PIKESVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21208-5329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-358-1111
Provider Business Practice Location Address Fax Number:
443-261-0850
Provider Enumeration Date:
03/21/2011