Healthcare Provider Details

I. General information

NPI: 1982106357
Provider Name (Legal Business Name): TOTAL YOU BEHAVIORAL MEDICINE AND RESEARCH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 PISCATAWAY RD
CLINTON MD
20735-2549
US

IV. Provider business mailing address

9135 PISCATAWAY RD STE 410
CLINTON MD
20735-2555
US

V. Phone/Fax

Practice location:
  • Phone: 240-383-4800
  • Fax: 240-846-1533
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMOS WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-383-4800