Organization
MIND MAP WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN JAMES BOLLAND LCPS (SOLE MEMBER/OWNER)
(410) 929-1499
Entity
Organization
Contact information
Practice address
53 WANOMA CIRCLE, REHOBOTH BEACH, DE 19971-7704
(410) 929-1499
Mailing address
3030 GREENMOUNTE AVE, STE 300 PMB 183594, BALTIMORE, MD 21218
(410) 929-1499
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC9569
LICENSED CLINICAL PROFESSIONAL COUNSELOR
MD
Enumeration date
08/09/2024
Last updated
08/09/2024
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