Provider Demographics
NPI:1952151714
Name:A & M WELLNESS RESOURCES
Entity Type:Organization
Organization Name:A & M WELLNESS RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:BISANGA
Authorized Official - Last Name:DZATI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:240-468-5873
Mailing Address - Street 1:14304 DRIFTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3044
Mailing Address - Country:US
Mailing Address - Phone:240-468-5873
Mailing Address - Fax:
Practice Address - Street 1:14304 DRIFTWOOD RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3044
Practice Address - Country:US
Practice Address - Phone:240-468-5873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty