# ELL.E WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326891706
- **Authorized official:** MR. LIONEL M KUM PA-C (CLINICIAN)
- **Authorized official phone:** (443) 421-1291

## Contact information

- **Practice address:** 205 CENTER ST STE 205, MOUNT AIRY, MD 21771-5499
- **Practice address phone:** (301) 703-8052
- **Mailing address:** 205 CENTER ST STE 205, MOUNT AIRY, MD 21771-5499
- **Mailing address phone:** (301) 703-8052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 132700000X | Dietary Manager | — | NULL | — |
| 132700000X | Dietary Manager | — | — | — |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 04/08/2024
- **Last updated:** 07/11/2024