| NPI | 1811573959 |
|---|---|
| Doing Business As | REVOLUTIONARY WELLNESS |
| Entity Type | Organization |
| Authorized Contact | DAWN PRATHER Owner 301-254-2446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 104100000X Social Worker | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2022-07-21 |