Provider Demographics
NPI:1003408105
Name:KEY THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:KEY THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGIACINTO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:410-227-5550
Mailing Address - Street 1:114 BROADVIEW BLVD N
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2602
Mailing Address - Country:US
Mailing Address - Phone:410-227-5550
Mailing Address - Fax:
Practice Address - Street 1:1800 JFK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-7402
Practice Address - Country:US
Practice Address - Phone:410-227-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty