MEDICARE: MPB GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	1770	MD

General Provider Information

NPI Number	:	1316375579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MPB GROUP INC

Provider Business Mailing Address
First Line	:	5840 BANNEKER RD STE 270
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3103
Country	:	US
Telephone Number	:	410-730-2385
Fax Number	:

Provider Business Practice Location Address
First Line	:	5840 BANNEKER RD STE 270
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3103
Country	:	US
Telephone Number	:	410-730-2385
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. MAGALIE PIOU-BREWER
Credential	:	PSY.D.
Telephone Number	:	410-730-2385

Provider Enumeration Date	:	10/28/2013
Last Update Date	:	03/31/2016

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