Organization
ACTIVE MINDZ, LLC.
Active
Other names
Active Mindz, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN WILSON LCSW-C (CLINICAL THERAPIST)
(410) 967-6873
Entity
Organization
Contact information
Practice address
205 RIVER WAY COURT, APT. 202, OWINGS MILLS, MD 21117
(410) 967-6873
Mailing address
205 RIVER WAY COURT, APT. 202, OWINGS MILLS, MD 21117
(410) 967-6873
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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