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
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
11/03/2021
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