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1588149009
LARRY BASTFIELD
BALTIMORE, MD
NPI
1588149009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-10-01
Last Update Date
2018-10-01
Business Address
Mr. LARRY BASTFIELD
5404 REISTERSTOWN RD
BALTIMORE, MD 21215-4403
Phone number: 410-764-0590
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Mailing Address
Mr. LARRY BASTFIELD
5404 REISTERSTOWN RD
BALTIMORE, MD 21215-4403
Phone number: 410-764-0590
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