| Adaptive Therapy, Inc. | |
|
109 La Grange Ave Suite 102 La Plata MD 20646-9592 | |
| (240) 253-7051 | |
| (301) 934-2640 |
| Full Name | Adaptive Therapy, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 109 La Grange Ave, La Plata, Maryland |
| Authorized Official Name and Position | Olimpia F Etts (PARTNER) |
| Authorized Official Contact | 9175767237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adaptive Therapy, Inc. 6015 New Forest Ct Apt 5 Waldorf MD 20603-4735 Ph: (240) 607-9207 | Adaptive Therapy, Inc. 109 La Grange Ave Suite 102 La Plata MD 20646-9592 Ph: (240) 253-7051 |
| NPI Number | 1013375757 |
|---|---|
| Provider Enumeration Date | 02/09/2016 |
| Last Update Date | 02/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013375757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 15217 (Maryland) | Primary |
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