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General NPI Number Information
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NPI Number | 1760905434
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Entity Type | Organization
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Legal Business Name | ENRICHMENT WELLNESS, LLC
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 839 QUINCE ORCHARD BLVD STE G
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1614
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Country | US
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Telephone | 202-701-7738
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Fax |
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Provider Business Mailing Address
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Address Line | 839 QUINCE ORCHARD BLVD STE G
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1614
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Country | US
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Telephone | 202-701-7738
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR, THERAPIST
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Name | OLGA RICH
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Credential | LCPC
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Telephone | 202-701-7738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | LC7857
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License Number State | MD
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