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General NPI Number Information
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NPI Number | 1578485157
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Entity Type | Organization
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Legal Business Name | WELLNESS ENTREATED & RESTORED LLC
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 1013 BEARDS HILL RD STE 101M-122
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City | ABERDEEN
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State | MD
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Zip | 21001-2293
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Country | US
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Telephone | 718-236-0774
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Fax | 410-272-4750
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Provider Business Mailing Address
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Address Line | 1013 BEARDS HILL RD STE 101-M122
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City | ABERDEEN
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State | MD
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Zip | 21001-2293
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Country | US
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Telephone | 718-236-0774
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Fax | 410-272-4750
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. KIMARA ROSITA RUNCIE
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Credential | LMHC, LCPC
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Telephone | 347-656-0174
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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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