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General NPI Number Information
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NPI Number | 1578130357
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Entity Type | Organization
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Legal Business Name | MY HEALTH, LLC
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 14502 GREENVIEW DR # 500-L21
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City | LAUREL
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State | MD
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Zip | 20708-3287
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Country | US
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Telephone | 202-390-6990
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Fax | 940-514-9077
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Provider Business Mailing Address
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Address Line | 3425 LONDONLEAF LN
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City | LAUREL
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State | MD
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Zip | 20724-2902
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Country | US
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Telephone | 301-728-3574
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MYRIAM DIATTA
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Credential | NP
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Telephone | 301-728-3574
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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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