| Kiddie Koach Prp Llc. | |
|
9922 Liberty Rd Randallstown MD 21133-1804 | |
| (443) 657-3345 | |
| Not Available |
| Full Name | Kiddie Koach Prp Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9922 Liberty Rd, Randallstown, Maryland |
| Authorized Official Name and Position | Nicole Price (FOUNDER) |
| Authorized Official Contact | 4436573345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiddie Koach Prp Llc. 9922 Liberty Rd Randallstown MD 21133-1804 Ph: (443) 657-3345 | Kiddie Koach Prp Llc. 9922 Liberty Rd Randallstown MD 21133-1804 Ph: (443) 657-3345 |
| NPI Number | 1376000158 |
|---|---|
| Provider Enumeration Date | 02/27/2019 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376000158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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