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General NPI Number Information
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NPI Number | 1669337226
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Entity Type | Organization
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Legal Business Name | BALANCED RESILIENCE MENTAL HEALTH
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1311 LONDONTOWN BLVD STE 130A
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City | ELDERSBURG
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State | MD
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Zip | 21784-6439
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Country | US
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Telephone | 410-552-0773
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Fax |
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Provider Business Mailing Address
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Address Line | 4827 BUFFALO RD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-8223
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Country | US
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Telephone | 443-386-3396
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER ANN FRY
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Credential | CRNP PMH
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Telephone | 443-386-3396
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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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