| Led Life, Llc | |
|
3505 Ellicott Mills Dr Ste A2 Ellicott City MD 21043-4578 | |
| (507) 533-5433 | |
| Not Available |
| Full Name | Led Life, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3505 Ellicott Mills Dr Ste A2, Ellicott City, Maryland |
| Authorized Official Name and Position | Bergina Isbell (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 5075335441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Led Life, Llc Po Box 6500 Columbia MD 21045-6500 Ph: (507) 533-5433 | Led Life, Llc 3505 Ellicott Mills Dr Ste A2 Ellicott City MD 21043-4578 Ph: (507) 533-5433 |
| NPI Number | 1659988400 |
|---|---|
| Provider Enumeration Date | 09/25/2020 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659988400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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