Provider Demographics
NPI:1578224796
Name:INTANGIBLE WELLNESS
Entity Type:Organization
Organization Name:INTANGIBLE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOSS-MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-399-9823
Mailing Address - Street 1:3555 TRIBECA TRL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1445
Mailing Address - Country:US
Mailing Address - Phone:443-399-9823
Mailing Address - Fax:
Practice Address - Street 1:8808 CENTRE PARK DR STE 301
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2224
Practice Address - Country:US
Practice Address - Phone:443-399-9823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty