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General NPI Number Information
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NPI Number | 1689207607
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Entity Type | Organization
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Legal Business Name | HARFORD HEALTH AND WELLNESS
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 4 NORTH AVE STE 420
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City | BEL AIR
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State | MD
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Zip | 21014-2314
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Country | US
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Telephone | 443-206-8326
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Fax |
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Provider Business Mailing Address
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Address Line | 4 NORTH AVE STE 420
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City | BEL AIR
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State | MD
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Zip | 21014-2314
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Country | US
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Telephone | 443-206-8326
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRANDON JOSEPH PHILLIPS
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Credential | PMHNP-BC
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Telephone | 443-206-8326
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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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