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NPI Code Detail

MEDICARE: EMPOWER MINDS,TRANSFORM LIVES LLC

MEDICARE: EMPOWER MINDS,TRANSFORM LIVES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1902637218
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPOWER MINDS,TRANSFORM LIVES LLC
Provider Business Mailing Address
First Line : 9902 PEONY LN
Second Line :
City : LAUREL
State : MD
Zip : 20723-6024
Country : US
Telephone Number : 571-201-0273
Fax Number :
Provider Business Practice Location Address
First Line : 8865 STANFORD BLVD STE 202
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-5422
Country : US
Telephone Number : 240-676-1668
Fax Number :
Authorized Official
Title or Position : MANAGING DIRECTOR
Name : MR. VINOD KUMAR
Credential :
Telephone Number : 571-201-0273
Provider Enumeration Date : 08/08/2024
Last Update Date : 08/08/2024

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Directions to “EMPOWER MINDS,TRANSFORM LIVES LLC ” Practice Location

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