| Organization Name: | THERAPY @ 9811 INC |
| NPI Number: | 1376823823 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACCQUELINE SOMERVILLE (OWNER/ CEO) |
| Mailing Address: | 9811 Mallard Dr Suite 210/211 Laurel |
| State: | MD US |
| Postal Code: | 207083143 |
| Phone Number: | 3015253205 |
| Fax Number: | |
| NPI Enumeration Date: | 08/27/2011 |
| NPI Last Update Date: | 11/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LC2025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |