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General NPI Number Information
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NPI Number | 1760250518
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Entity Type | Organization
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Legal Business Name | HEALTHY MIND-HEALTHY BODY LLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 11299 OWINGS MILLS BLVD STE 303
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2902
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Country | US
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Telephone | 443-805-1664
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Fax |
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Provider Business Mailing Address
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Address Line | 4607 KINGS MILL WAY
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City | OWINGS MILLS
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State | MD
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Zip | 21117-6186
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Country | US
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Telephone | 443-805-1664
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAREEN CAMPBELL
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Credential |
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Telephone | 443-680-0361
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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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