Organization
MILESTONE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH G ADEDEJI PMHNP (PRESIDENT)
(240) 755-1056
Entity
Organization
Contact information
Practice address
370A MAIN ST, LAUREL, MD 20707-4133
(240) 755-1056
Mailing address
12817 FOX FERN LN, CLARKSBURG, MD 20871-4040
(240) 755-1056
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/30/2020
Last updated
02/04/2021
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