| Botanic Wellness, Llc | |
|
5528 Belair Rd Ste 2 Baltimore MD 21206-3659 | |
| (443) 220-7296 | |
| Not Available |
| Full Name | Botanic Wellness, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5528 Belair Rd Ste 2, Baltimore, Maryland |
| Authorized Official Name and Position | Dashaira Bennnett (CEO/OWNER) |
| Authorized Official Contact | 4432207296 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Botanic Wellness, Llc 802 Melville Ave Baltimore MD 21218-2555 Ph: (443) 220-7296 | Botanic Wellness, Llc 5528 Belair Rd Ste 2 Baltimore MD 21206-3659 Ph: (443) 220-7296 |
| NPI Number | 1447038757 |
|---|---|
| Provider Enumeration Date | 09/18/2023 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/18/2023 |
| Medicare PECOS PAC ID | 7517408842 |
|---|---|
| Medicare Enrollment ID | O20240926000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447038757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dashaira Keyanna Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679270680 PECOS PAC ID: 4183082050 Enrollment ID: I20230626000454 |
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