Provider Demographics
NPI:1457244089
Name:HEALING WELLNESS MASSAGE LLC
Entity type:Organization
Organization Name:HEALING WELLNESS MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCLARE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:410-507-7158
Mailing Address - Street 1:55 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1803
Mailing Address - Country:US
Mailing Address - Phone:410-507-7158
Mailing Address - Fax:
Practice Address - Street 1:8338 VETERANS HWY STE 205B
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2637
Practice Address - Country:US
Practice Address - Phone:410-507-7158
Practice Address - Fax:410-544-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty