Organization
MONTGOMERY WELLNESS HUB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED KOLAWOLE IBRAHIM (CEO)
(240) 246-7837
Entity
Organization
Contact information
Practice address
951 RUSSELL AVE STE D, GAITHERSBURG, MD 20879-3283
(301) 404-7336
(240) 246-7911
Mailing address
951 RUSSELL AVE STE D, GAITHERSBURG, MD 20879-3283
(301) 404-7336
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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