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Organization
BRIDGES TO WELLNESS CENTRE LLC
Active
Organization
BRIDGES TO WELLNESS CENTRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY L COOPER CRNP (CEO/FOUNDER)
(848) 220-6659
Entity
Organization
Contact information
Practice address
12522 GREAT PARK CIR APT 303, GERMANTOWN, MD 20876-5985
(848) 220-6659
Mailing address
PO BOX 2718, GERMANTOWN, MD 20875-2718
(848) 220-6659
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
01/25/2023
Last updated
12/21/2023
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