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General NPI Number Information
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NPI Number | 1083178586
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALING WORKS WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 1576 MERRITT BLVD STE 8
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City | DUNDALK
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State | MD
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Zip | 21222-2114
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Country | US
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Telephone | 443-530-6533
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Fax | 443-530-6996
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Provider Business Mailing Address
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Address Line | 750 CONCOURSE CIR STE 103-203
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2995
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Country | US
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Telephone | 443-530-6533
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Fax | 443-503-8250
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | ROSE LYNCH
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Credential |
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Telephone | 401-649-5754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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