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General NPI Number Information
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NPI Number | 1770492555
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Entity Type | Organization
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Legal Business Name | FOURROOTS WELLNESS AND CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 09/05/2026
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 10007 CAMPUS WAY S
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-2103
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Country | US
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Telephone | 240-705-3032
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Fax |
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Provider Business Mailing Address
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Address Line | 10007 CAMPUS WAY S
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-2103
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Country | US
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Telephone | 240-705-3032
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | DR. CHIOMA K OPARA
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Credential | LGPC
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Telephone | 240-705-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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