Beyond Dynamic Potential Llc | |
15230 Regina Dr Brandywine MD 20613-4225 | |
(240) 844-2441 | |
Not Available |
Full Name | Beyond Dynamic Potential Llc |
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Speciality | Social Worker |
Location | 15230 Regina Dr, Brandywine, Maryland |
Authorized Official Name and Position | Stephanie M Brown-gilbert (OWNER) |
Authorized Official Contact | 2408442441 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Beyond Dynamic Potential Llc 15230 Regina Dr Brandywine MD 20613-4225 Ph: (240) 844-2441 | Beyond Dynamic Potential Llc 15230 Regina Dr Brandywine MD 20613-4225 Ph: (240) 844-2441 |
NPI Number | 1184365462 |
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Provider Enumeration Date | 04/02/2022 |
Last Update Date | 04/02/2022 |
Certification Date | 04/02/2022 |
Medicare PECOS PAC ID | 8022491919 |
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Medicare Enrollment ID | O20220809004140 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184365462 | NPI | - | NPPES |
212130100 | Medicaid | MD |
Provider Name | Stephanie M Brown |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1134525959 PECOS PAC ID: 8921433129 Enrollment ID: I20220809004142 |
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