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General NPI Number Information
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NPI Number | 1477247716
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Entity Type | Organization
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Legal Business Name | ECOBLOSSOM INC
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 3815 FERNHILL AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5618
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Country | US
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Telephone | 667-127-9262
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 FERNHILL AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5618
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Country | US
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Telephone | 667-217-9262
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | AUGUSTINA NWAKAEGO OGBUJI
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Credential | CMT
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Telephone | 667-217-7962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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