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General NPI Number Information
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NPI Number | 1275499535
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Entity Type | Organization
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Legal Business Name | KUB WELLNESS LLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 16701 MELFORD BLVD STE 400
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City | BOWIE
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State | MD
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Zip | 20715-4411
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Country | US
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Telephone | 301-741-5828
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Fax |
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Provider Business Mailing Address
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Address Line | 621 GLEN LAKE DR
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City | BOWIE
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State | MD
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Zip | 20716-3558
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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 | PMHNP
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Name | BOLANLE SABA
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Credential | APRN
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Telephone | 301-741-5828
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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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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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