Provider Demographics
NPI:1508662610
Name:HOLISTIC THERAPEUTIC WELLNESS
Entity type:Organization
Organization Name:HOLISTIC THERAPEUTIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:ERNESTINE
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:240-988-4007
Mailing Address - Street 1:11887 WINGED FOOT CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3258
Mailing Address - Country:US
Mailing Address - Phone:240-988-4007
Mailing Address - Fax:
Practice Address - Street 1:11887 WINGED FOOT CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3258
Practice Address - Country:US
Practice Address - Phone:240-988-4007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty