Issaiah House - Professional Counselor in Baltimore, Maryland | ProviderWire

Legal Business Name

Issaiah House

NPI Number

1508388364

NPI Type

Organization

Enumeration Date

07/13/2017

Specialties

(Taxonomies)

Name

Professional Counselor

Code

101YP2500X

Primary Taxonomy

Yes

Licenses

State

Maryland

License Number

LC7034

Contact
Information

Purpose

Mailing

Location

Address

4331 PARKTON ST

2802 HARFORD RD

City

Baltimore

Baltimore

State

MD

MD

Postal Code

21229-4521

21218-4953

Country

US

US

Telephone Number

(443) 882-1943

(443) 882-1943

Authorized Official

Name

Darryl Braxton

Title or Position

OWNER

Telephone Number

(443) 882-1943

Identifiers

Identifier

250016700

Identifier State

MD

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/10/2020

Provider Address

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