| For Wellness, Llc | |
|
10003 Ruffian Way Unit B Laurel MD 20723-2088 | |
| (240) 706-0748 | |
| Not Available |
| Full Name | For Wellness, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10003 Ruffian Way Unit B, Laurel, Maryland |
| Authorized Official Name and Position | Jasmine Tierra Lache White (PSYCHOTHERAPIST / OWNER) |
| Authorized Official Contact | 2407060748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| For Wellness, Llc 10003 Ruffian Way Unit B Laurel MD 20723-2088 Ph: (240) 706-0748 | For Wellness, Llc 10003 Ruffian Way Unit B Laurel MD 20723-2088 Ph: (240) 706-0748 |
| NPI Number | 1053049544 |
|---|---|
| Provider Enumeration Date | 08/11/2022 |
| Last Update Date | 08/11/2022 |
| Certification Date | 08/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053049544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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