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General NPI Number Information
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NPI Number | 1164350617
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Entity Type | Organization
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Legal Business Name | GIFT OF LIFE
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 15107 INTERLACHEN DR # 2-703
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City | SILVER SPRING
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State | MD
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Zip | 20906-5625
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Country | US
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Telephone | 410-978-0001
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Fax |
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Provider Business Mailing Address
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Address Line | 15107 INTERLACHEN DR # 2-703
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City | SILVER SPRING
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State | MD
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Zip | 20906-5625
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Country | US
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Telephone | 410-978-0001
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MS. NEZHLA BOZORGMAND MOMAYEZI II
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Credential | LCPC
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Telephone | 410-978-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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