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1265039549
WELLNESS LEGACY LLC
BEL AIR, MD
NPI
1265039549
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Entity Type
Organization
Authorized Contact
LERA ISON
Co Owner
410-286-1258
Organization Subpart ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2020-10-08
Last Update Date
2024-03-27
Business Address
WELLNESS LEGACY LLC
260 GATEWAY DR STE 13
BEL AIR, MD 21014-4268
Phone number: 410-286-1258
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Mailing Address
WELLNESS LEGACY LLC
1539 BLAKES LEGACY DR
BEL AIR, MD 21014-1946
Phone number: 817-319-6878
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