Healthcare Provider Details

I. General information

NPI: 1407781545
Provider Name (Legal Business Name): OBRIEN L WIMBISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7309 RIVERDALE RD
LANHAM MD
20706-1133
US

IV. Provider business mailing address

7309 RIVERDALE RD
LANHAM MD
20706-1133
US

V. Phone/Fax

Practice location:
  • Phone: 301-306-6363
  • Fax: 301-306-6363
Mailing address:
  • Phone: 301-306-6363
  • Fax: 301-306-6363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. OBRIEN L WIMBISH
Title or Position: CEO
Credential:
Phone: 202-753-9734