Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | SC0436 | MD |
NPI | 1003939505 |
---|---|
Provider Name | Ms. Tamar A Johnson - Bey |
First Address | Baltimore, MD 21229-1012 |
Second Address | Baltimore, MD 21223-1749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |