Organization
MOUNTAIN VALLEY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERGINA BRICKHOUSE ISBELL MD (CHIEF MEDICAL OFFICER)
(507) 405-4598
Entity
Organization
Contact information
Practice address
1400 W LOMBARD ST, BALTIMORE, MD 21223-3134
(507) 405-4598
Mailing address
PO BOX 6500, COLUMBIA, MD 21045-6500
(507) 405-4598
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/09/2021
Last updated
05/20/2024
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