| Neurospark Health Pllc | |
|
23330 Holly Park Dr Preston MD 21655-1817 | |
| (206) 802-4259 | |
| Not Available |
| Full Name | Neurospark Health Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 23330 Holly Park Dr, Preston, Maryland |
| Authorized Official Name and Position | Julie M Landry (OWNER) |
| Authorized Official Contact | 2068024259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurospark Health Pllc 23330 Holly Park Dr Preston MD 21655-1817 Ph: (206) 802-4259 | Neurospark Health Pllc 23330 Holly Park Dr Preston MD 21655-1817 Ph: (206) 802-4259 |
| NPI Number | 1174345029 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174345029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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