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General NPI Number Information
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NPI Number | 1760362487
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Entity Type | Organization
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Legal Business Name | ON EAGLES WINGS RESTORATIVE HEALTH SERVICES
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 669 BEL AIR RD # 1152
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City | BEL AIR
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State | MD
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Zip | 21014-4306
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Country | US
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Telephone | 410-656-9880
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Fax |
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Provider Business Mailing Address
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Address Line | 669 BEL AIR RD # 1152
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City | BEL AIR
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State | MD
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Zip | 21014-4306
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/PROVIDER
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Name | NAA DICKSON
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Credential | BSN, PMHNP-BC, FNP-C
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Telephone | 410-908-0944
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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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