Organization
BOLDLY WHOLE, LLC
Active
Other names
Boldly Whole, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY D WILSON LICSW (CLINICAL SOCIAL WORKER)
(718) 877-0633
Entity
Organization
Contact information
Practice address
6721 CATHEDRAL AVE, LANHAM, MD 20706-3701
(718) 877-0633
Mailing address
5557 BALTIMORE AVE STE 500-1099, HYATTSVILLE, MD 20781-1922
(202) 858-3816
(202) 788-6520
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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