Healthcare Provider Details

I. General information

NPI: 1053259572
Provider Name (Legal Business Name): SNOBS UNLEASHED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 21ST ST NE
WASHINGTON DC
20002-4705
US

IV. Provider business mailing address

435 21ST ST NE
WASHINGTON DC
20002-4705
US

V. Phone/Fax

Practice location:
  • Phone: 202-903-4469
  • Fax:
Mailing address:
  • Phone: 202-903-4469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LONDON WARD
Title or Position: CEO
Credential:
Phone: 202-903-4469