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General NPI Number Information
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NPI Number | 1801565320
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Entity Type | Organization
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Legal Business Name | ELEMENTS OF WELLNESS LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 8104 VALLEY LN
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-3434
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Country | US
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Telephone | 443-717-0131
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Fax |
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Provider Business Mailing Address
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Address Line | 8104 VALLEY LN
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-3434
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Country | US
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Telephone | 443-717-0131
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Fax |
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Authorized Official
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Title or Position | NP
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Name | RACHEL ONDRISH
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Credential |
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Telephone | 443-717-0131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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