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General NPI Number Information
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NPI Number | 1356253165
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Entity Type | Organization
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Legal Business Name | FRF DYNAMIC SERVICES LLC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 5324 THOMAS SIM LEE TER
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-7422
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Country | US
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Telephone | 227-770-0744
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Fax |
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Provider Business Mailing Address
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Address Line | 5324 THOMAS SIM LEE TER
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-7422
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Country | US
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Telephone | 227-770-0744
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER - PSYCH/MENTAL H
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Name | FUNMILAYO RITA FASHOLA
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Credential | PMHNP
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Telephone | 227-770-0744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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