Intentional Healing Space

NPI #1972989150 in Windsor Mill, Maryland

Provider Information

NPI Number: 1972989150
Entity Type: Organization
Organization Name: Intentional Healing Space
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 10, 2015
Last Updated: Aug 10, 2015

Practice Location

Address: 8517 GREENS LN
City: Windsor Mill
State: Maryland
ZIP Code: 21244-1124
Phone: (410) 733-2055

Authorized Official

Name: JEREMY P DARDEN
Title: OWNER
Phone: (410) 733-2055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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