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General NPI Number Information
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NPI Number | 1952800237
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Entity Type | Organization
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Legal Business Name | EMPOWERED HEALTH INC
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 4909 LIBERTY HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21207-7052
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Country | US
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Telephone | 443-221-0566
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11305
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City | BALTIMORE
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State | MD
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Zip | 21239-0305
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Country | US
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Telephone | 443-221-0566
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | EVETTE GRIFFIN
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Credential |
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Telephone | 443-221-0566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7194
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R144895
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7097
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License Number State | MD
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