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General NPI Number Information
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NPI Number | 1740177294
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Entity Type | Organization
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Legal Business Name | B'MORE MENTAL HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 711 W 40TH ST STE 206
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City | BALTIMORE
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State | MD
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Zip | 21211-2108
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Country | US
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Telephone | 410-842-6055
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Fax |
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Provider Business Mailing Address
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Address Line | 711 W 40TH ST STE 206
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City | BALTIMORE
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State | MD
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Zip | 21211-2108
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Country | US
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Telephone | 410-842-6055
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE CORNELL
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Credential |
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Telephone | 410-842-6055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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