Authentic Release INC
NPI #1720869548 in Glen Burnie, Maryland
Provider Information
- NPI Number
- 1720869548
- Entity Type
- Organization
- Organization Name
- Authentic Release INC
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Oct 9, 2023
- Last Updated
- Oct 9, 2023
Practice Location
- Address
- 1406B CRAIN HWY S STE 306
- City
- Glen Burnie
- State
- Maryland
- ZIP Code
- 21061-4094
- Phone
- (301) 804-0344
Authorized Official
- Name
- SHANNON MARTIN, CRNP
- Title
- OWNER
- Phone
- (301) 804-0344
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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