Provider Demographics
NPI:1245891621
Name:HEALING ARTS WELLNESS LLC
Entity type:Organization
Organization Name:HEALING ARTS WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:IVANILOVA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:240-630-0597
Mailing Address - Street 1:6017 SOUTHPORT DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1847
Mailing Address - Country:US
Mailing Address - Phone:240-498-5286
Mailing Address - Fax:
Practice Address - Street 1:TAVO TOTAL HEALTH
Practice Address - Street 2:407 LEIGHTON AVE
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:240-630-0597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty