Healthcare Provider Details

I. General information

NPI: 1174302707
Provider Name (Legal Business Name): DIAMOND MIND & BODY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8507 OXON HILL RD STE 200
FORT WASHINGTON MD
20744-4774
US

IV. Provider business mailing address

8507 OXON HILL RD STE 200
FORT WASHINGTON MD
20744-4774
US

V. Phone/Fax

Practice location:
  • Phone: 888-574-7165
  • Fax:
Mailing address:
  • Phone: 888-574-7165
  • Fax: 888-236-3234

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: NWAMAKA ONYEOGO
Title or Position: APN
Credential:
Phone: 888-574-7165