Divine Wellness INC
NPI #1821656901 in Randallstown, Maryland
Provider Information
- NPI Number
- 1821656901
- Entity Type
- Organization
- Organization Name
- Divine Wellness INC
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Jun 3, 2019
- Last Updated
- Jun 3, 2019
Practice Location
- Address
- 9633 LIBERTY RD STE K
- City
- Randallstown
- State
- Maryland
- ZIP Code
- 21133-2435
- Phone
- (443) 272-2207
Authorized Official
- Name
- MR. OLUSEGUN ADEWALE SOFOWOTE, LPN
- Title
- EXECUTIVE DIRECTOR
- Phone
- (443) 272-2207
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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