Provider Demographics
NPI:1407633928
Name:DESIGN FOR YOUR SOUL
Entity Type:Organization
Organization Name:DESIGN FOR YOUR SOUL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIMER-JAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-925-1422
Mailing Address - Street 1:6274 WHITE BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6274 WHITE BIRCH RD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-8528
Practice Address - Country:US
Practice Address - Phone:410-925-1422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty