Healthcare Provider Details

I. General information

NPI: 1851080386
Provider Name (Legal Business Name): BE THE CHANGE HEALTH & WELLNESS CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8808 CENTRE PARK DR STE 301
COLUMBIA MD
21045-2224
US

IV. Provider business mailing address

8808 CENTRE PARK DR STE 301
COLUMBIA MD
21045-2224
US

V. Phone/Fax

Practice location:
  • Phone: 301-970-9724
  • Fax:
Mailing address:
  • Phone: 301-970-9724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SULTANA AFROOZ
Title or Position: OWNER
Credential: DO
Phone: 301-970-9724