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General NPI Number Information
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NPI Number | 1336705797
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Entity Type | Organization
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Legal Business Name | HEALTHY PATH, LLC
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Dates
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Enumeration Date | 05/11/2019
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Last Update Date | 05/11/2019
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Provider Practice Location Address
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Address Line | 10630 LITTLE PATUXENT PKWY STE 210
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City | COLUMBIA
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State | MD
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Zip | 21044-6204
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Country | US
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Telephone | 410-730-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 11445 BUTTERFRUIT WAY
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-1443
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Country | US
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Telephone | 443-926-3352
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANAHITA MARYAM SEYEDAN
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Credential | DOM, LAC, MAC, MS
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Telephone | 410-730-1074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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