Healthcare Provider Details

I. General information

NPI: 1386187581
Provider Name (Legal Business Name): ONE STEP FORWARD WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 BUSINESS PKWY SUITE L
LANHAM MD
20706-1840
US

IV. Provider business mailing address

9901 BUSINESS PKWY SUITE L
LANHAM MD
20706-1840
US

V. Phone/Fax

Practice location:
  • Phone: 301-731-0003
  • Fax:
Mailing address:
  • Phone: 301-731-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBIN PITTS
Title or Position: OWNER
Credential:
Phone: 301-731-0003