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Organization
ESHCOL BEHAVIORAL SERVICES LLC
Active
Organization
ESHCOL BEHAVIORAL SERVICES LLC
Active
Other names
Eshcol Behavioral Services llc
Organization subpart
No
Provider details
NPI number
Authorized official
AKHERE GWAN NP (PSYCHIATRIC NURSE PRACTITIONER)
(617) 461-3856
Entity
Organization
Contact information
Practice address
6223 SWEET GUM LN, HANOVER, MD 21076-2127
(617) 461-3856
Mailing address
6223 SWEET GUM LN, HANOVER, MD 21076-2127
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
11/03/2021
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