Healthcare Provider Details

I. General information

NPI: 1669390217
Provider Name (Legal Business Name): ULIFTINGU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3813 ECHODALE AVE
BALTIMORE MD
21206-4116
US

IV. Provider business mailing address

3813 ECHODALE AVE
BALTIMORE MD
21206-4116
US

V. Phone/Fax

Practice location:
  • Phone: 443-630-9622
  • Fax:
Mailing address:
  • Phone: 443-630-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARLENE REID
Title or Position: OWNER
Credential:
Phone: 443-630-9622