Your Wellness Sources | |
4301 Garden City Dr Ste 304 Hyattsville MD 20785-6105 | |
(301) 235-0060 | |
Not Available |
Full Name | Your Wellness Sources |
---|---|
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 4301 Garden City Dr Ste 304, Hyattsville, Maryland |
Authorized Official Name and Position | Marshalee George (MEDICAL DIRECTOR) |
Authorized Official Contact | 3012350060 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Your Wellness Sources 6305 Ivy Ln Ste 101 Greenbelt MD 20770-6326 Ph: (301) 235-0060 | Your Wellness Sources 4301 Garden City Dr Ste 304 Hyattsville MD 20785-6105 Ph: (301) 235-0060 |
NPI Number | 1205339413 |
---|---|
Provider Enumeration Date | 03/14/2018 |
Last Update Date | 11/13/2020 |
Certification Date | 11/13/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205339413 | NPI | - | NPPES |
600082701 | Medicaid | MD | |
192174600 | Medicaid | MD | |
601006700 | Medicaid | MH | |
600082700 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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