Baltimore Ketamine Clinic
NPI #1972145381 in Sparks Glencoe, Maryland
Provider Information
- NPI Number
- 1972145381
- Entity Type
- Organization
- Organization Name
- Baltimore Ketamine Clinic
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Oct 17, 2019
- Last Updated
- May 15, 2025
Practice Location
- Address
- 909 RIDGEBROOK RD STE 202
- City
- Sparks Glencoe
- State
- Maryland
- ZIP Code
- 21152-9476
- Phone
- (410) 870-5482
Authorized Official
- Name
- IVANA MITIC, CRNA
- Title
- GROUP OWNER
- Phone
- (713) 412-3462
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Infusion Therapy — Infusion Therapy |
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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