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1548670870
IVY PRIDGEN
BALTIMORE, MD
NPI
1548670870
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD SC1867)
Enumeration Date
2014-05-08
Last Update Date
2014-05-08
Business Address
-- IVY PRIDGEN
1111 WASHINGTON BLVD
BALTIMORE, MD 21230-1824
Phone number: 410-467-6040
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Mailing Address
-- IVY PRIDGEN
PO BOX 33109
BALTIMORE, MD 21218-0401
Phone number: 410-467-6040
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