Healthcare Provider Details

I. General information

NPI: 1003448150
Provider Name (Legal Business Name): WELLNESS AND PEACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2020
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 40TH ST STE 404
BALTIMORE MD
21211-2110
US

IV. Provider business mailing address

401 SOUTHWAY
BALTIMORE MD
21218-2520
US

V. Phone/Fax

Practice location:
  • Phone: 410-575-3334
  • Fax:
Mailing address:
  • Phone: 202-731-9097
  • Fax: 301-971-9521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RITA A ABELLA
Title or Position: PRACTICE MANAGER
Credential: PHD
Phone: 202-731-9097