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General NPI Number Information
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NPI Number | 1215882063
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Entity Type | Organization
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Legal Business Name | MARYBIRD WELLNESS PARTNERS
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 20 E CHURCH ST STE 403
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City | MARTINSVILLE
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State | VA
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Zip | 24112-6208
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Country | US
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Telephone | 443-469-0291
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Fax |
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Provider Business Mailing Address
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Address Line | 20 E CHURCH ST STE 403
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City | MARTINSVILLE
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State | VA
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Zip | 24112-6208
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTAL HAMPTON
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Credential |
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Telephone | 443-469-0291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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