Organization
M & M MENTAL HEALTH AND WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW HALE MAURO CRNP-PMH (MEDICAL DIRECTOR)
(443) 845-4269
Entity
Organization
Contact information
Practice address
122 WAELCHLI AVE, HALETHORPE, MD 21227-2546
(443) 845-4269
Mailing address
122 WAELCHLI AVE, HALETHORPE, MD 21227-2546
(443) 845-4269
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154915387
—
MD
Enumeration date
07/19/2021
Last updated
07/19/2021
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