Provider Demographics
NPI:1861082752
Name:SOUND WELLNESS CENTER
Entity type:Organization
Organization Name:SOUND WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALLIBALOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP-PMH-BC
Authorized Official - Phone:410-559-6121
Mailing Address - Street 1:10999 RED RUN BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3249
Mailing Address - Country:US
Mailing Address - Phone:443-379-4596
Mailing Address - Fax:443-558-7005
Practice Address - Street 1:8890 MCDONOGH RD STE 208
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5397
Practice Address - Country:US
Practice Address - Phone:410-559-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty