| Body And Soul Wellness Center | |
|
9613 Harford Rd Ste 3 Parkville MD 21234-2150 | |
| (443) 714-0775 | |
| Not Available |
| Full Name | Body And Soul Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 9613 Harford Rd Ste 3, Parkville, Maryland |
| Authorized Official Name and Position | Shaquetta Little-young (OWNER) |
| Authorized Official Contact | 4437140775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Body And Soul Wellness Center 9613 Harford Rd Ste 3 Parkville MD 21234-2150 Ph: (443) 714-0775 | Body And Soul Wellness Center 9613 Harford Rd Ste 3 Parkville MD 21234-2150 Ph: (443) 714-0775 |
| NPI Number | 1811615370 |
|---|---|
| Provider Enumeration Date | 08/19/2022 |
| Last Update Date | 02/21/2023 |
| Certification Date | 02/21/2023 |
| Medicare PECOS PAC ID | 2860913241 |
|---|---|
| Medicare Enrollment ID | O20250303001653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811615370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shaquetta Little-young |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841871993 PECOS PAC ID: 9335660612 Enrollment ID: I20250303001899 |
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