Provider First Line Business Practice Location Address:
200 E. NORTH AVENUE
Provider Second Line Business Practice Location Address:
OFFICE OF PSYCHOLOGICAL SERVICES
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-579-5667
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2013