Healthcare Provider Details

I. General information

NPI: 1669185450
Provider Name (Legal Business Name): AUZI BEHAVIORAL & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 KERRIES CT
PERRY HALL MD
21128-9833
US

IV. Provider business mailing address

9800 KERRIES CT
PERRY HALL MD
21128-9833
US

V. Phone/Fax

Practice location:
  • Phone: 240-462-9213
  • Fax:
Mailing address:
  • Phone: 240-462-9213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. BLESSING IWUH
Title or Position: DIRECTOR
Credential: NP
Phone: 240-462-9213