Authentic Mental Wellness LLC
Nurse Practitioner, Psych/Mental Health in Gaithersburg, MD. Organization (NPI-2).
NPI number1801573605
StatusActive
Last updated in NPPESNov 14, 2024
Details
- NPI
- 1801573605
- Entity type
- Organization (NPI-2)
- Legal business name
- Authentic Mental Wellness LLC
- Organization subpart
- No
- Enumeration date
- Jul 3, 2023
- Certification date
- Nov 14, 2024
- Last updated
- Nov 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
10810 Darnestown Rd Ste 103Gaithersburg, MD 20878-2604
Phone 240-829-1863 · Fax 240-238-6187
Mailing address
10810 Darnestown Rd Ste 103Gaithersburg, MD 20878-2604
Phone 240-829-1863 · Fax 240-238-6187
Authorized official
Francine Kamhoua
Provider
7035086182
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