Organization
ICON CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THICKNESS PATRICK EGWUATU (OWNER OF ENTITY)
(202) 288-7752
Entity
Organization
Contact information
Practice address
7735 BELLE POINT DR, GREENBELT, MD 20770-3300
(240) 455-3166
(240) 455-4154
Mailing address
7735 BELLE POINT DR, GREENBELT, MD 20770-3300
(240) 455-3166
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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