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1669832028
MUNDRAE DALLAS WHITE
BALTIMORE, MD
NPI
1669832028
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD LCA2225)
Enumeration Date
2016-02-29
Last Update Date
2016-02-29
Business Address
-- MUNDRAE DALLAS WHITE LCADC
3218 MAYFAIR RD
BALTIMORE, MD 21207-4561
Phone number: 410-725-8611
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Mailing Address
-- MUNDRAE DALLAS WHITE LCADC
3218 MAYFAIR RD
BALTIMORE, MD 21207-4561
Phone number: 410-725-8611
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