Provider Demographics
NPI:1669181269
Name:HOLISTIC WELLNESS SERVICES LLC
Entity type:Organization
Organization Name:HOLISTIC WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OGEMDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-627-8407
Mailing Address - Street 1:739 BUTTERNUT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2419
Mailing Address - Country:US
Mailing Address - Phone:202-627-8407
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR SUITE
Practice Address - Street 2:SUITE 500 #1038
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708
Practice Address - Country:US
Practice Address - Phone:202-627-8407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty