Organization · Type 2 NPI
Baltimore Ketamine Clinic
Psychiatric/Mental Health Nurse Practitioner · Sparks Glencoe, MD
NPI number
1972145381
Active
Practice location
909 Ridgebrook Rd Ste 202
Sparks Glencoe, MD 21152-9476
Fax (410) 628-1212
Mailing address
1 Texas Station Ct Ste 320
Timonium, MD 21093-8290
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Infusion Therapy Clinic/Center | 261QI0500X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1972145381
Baltimore Ketamine Clinic's National Provider Identifier is 1972145381, issued on Oct 17, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Sparks Glencoe, MD. The record was last updated on May 15, 2025.