NPI 1023368412

Phoenix Support Services, LLC

Organisation Specialist Towson, MD

Practice location

Address: 6701 N Charles St STE 4104, Towson, MD 21204-6808
Phone: (410) 714-0077
Mailing address: 520 Stevenson Ln, Towson, MD 21286-7606

Authorised official

Name: James Robert Barry
Title: Owner/Psychologist
Phone: (410) 714-0077

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 04153 (MD)

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Registry record

NPI: 1023368412
Entity type: Organization
NPI issued: 13 Sep 2012
Record last updated: 13 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.