Organization
MJB HOLISTIC AND THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELVEENA JOHNSON-BOLDEN PMHNP-BC (CEO/NURSE PRACTITIONER)
(240) 301-1034
Entity
Organization
Contact information
Practice address
1300 MERCANTILE LN STE 129-14, UPPER MARLBORO, MD 20774-5327
(301) 381-3622
Mailing address
1300 MERCANTILE LN STE 129-14, UPPER MARLBORO, MD 20774-5327
(301) 381-3622
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B435599428868
DRIVERS LIC
MD
Enumeration date
02/07/2022
Last updated
05/22/2023
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