Provider Demographics
NPI:1447741459
Name:A STEP AHEAD PREVENTIVE AND HOLISTIC WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:A STEP AHEAD PREVENTIVE AND HOLISTIC WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLAR
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALHOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-377-1836
Mailing Address - Street 1:14933 NASHUA LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1005
Mailing Address - Country:US
Mailing Address - Phone:301-503-1519
Mailing Address - Fax:
Practice Address - Street 1:4500 FORBES BLVD # 200-W12
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-503-1519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03977103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty