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General NPI Number Information
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NPI Number | 1962273698
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Entity Type | Organization
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Legal Business Name | INNER BALANCE MENTAL HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 3422 HIGHWOOD DR SE
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City | WASHINGTON
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State | DC
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Zip | 20020-2344
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Country | US
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Telephone | 443-480-7510
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Fax |
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Provider Business Mailing Address
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Address Line | 5457 TWIN KNOLLS ROAD SUITE300 #1128
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City | COLUMBIA
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State | MD
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Zip | 21045
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Country | US
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Telephone | 443-480-7510
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | MS. LISA S TUBMAN
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Credential | NURSE PRACTITIONER
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Telephone | 443-480-7510
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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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