Organization
MINDFUL BEHAVIORAL OF MARYLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKILA PROCTOR (PRESIDENT)
(919) 697-0767
Entity
Organization
Contact information
Practice address
3109 PARKWAY, CHEVERLY, MD 20785-1256
(919) 697-0767
Mailing address
3109 PARKWAY, CHEVERLY, MD 20785-1256
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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