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General NPI Number Information
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NPI Number | 1972132264
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Entity Type | Organization
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Legal Business Name | WBMW WELLNESS CENTER LLC
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 3459 SAINT JOHNS LN STE 4
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-4025
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Country | US
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Telephone | 301-909-8150
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Fax | 301-909-8151
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Provider Business Mailing Address
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Address Line | 3459 SAINT JOHNS LN STE 4
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-4025
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Country | US
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Telephone | 301-909-8150
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Fax | 301-909-8151
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Authorized Official
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Title or Position | PRESIDENT
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Name | BILIKI S DOUGLAS
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Credential | PMHNP-BC
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Telephone | 301-909-8150
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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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