Provider Demographics
NPI:1720763246
Name:MY WELLNESS 1 INC
Entity Type:Organization
Organization Name:MY WELLNESS 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINETTE
Authorized Official - Middle Name:N
Authorized Official - Last Name:ZIBI
Authorized Official - Suffix:
Authorized Official - Credentials:DRNP
Authorized Official - Phone:240-253-3912
Mailing Address - Street 1:4531 32ND ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1613
Mailing Address - Country:US
Mailing Address - Phone:240-253-3912
Mailing Address - Fax:
Practice Address - Street 1:4531 32ND ST
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1613
Practice Address - Country:US
Practice Address - Phone:240-253-3912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty