Organization
MOMENTUM BEHAVIORAL HEALTH CONSULTANTS AND PARENT COACHING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLEEN MICHELLE WALLACE MD (PRESIDENT)
(504) 284-8837
Entity
Organization
Contact information
Practice address
6607 FANNON DR, BOWIE, MD 20720-4729
(504) 284-8837
Mailing address
6607 FANNON DR, BOWIE, MD 20720-4729
(504) 284-8837
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/24/2022
Last updated
05/24/2022
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