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General NPI Number Information
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NPI Number | 1992499743
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Entity Type | Organization
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Legal Business Name | AXIS HOLISTIC HEALTHCARE LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 9537 OAKHURST DR
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City | COLUMBIA
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State | MD
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Zip | 21046-2705
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Country | US
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Telephone | 667-231-1782
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Fax |
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Provider Business Mailing Address
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Address Line | 6925 OAKLAND MILLS RD # 116
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City | COLUMBIA
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State | MD
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Zip | 21045-4714
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Country | US
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Telephone | 667-231-1782
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. ROBIN MARTINEZ
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Credential | FNP-BC
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Telephone | 667-231-1782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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