Healthcare Provider Details

I. General information

NPI: 1174499362
Provider Name (Legal Business Name): SWALLOWING WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4641 MONTGOMERY AVE STE 300
BETHESDA MD
20814-3430
US

IV. Provider business mailing address

4641 MONTGOMERY AVE STE 300
BETHESDA MD
20814-3430
US

V. Phone/Fax

Practice location:
  • Phone: 301-288-1313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: IANESSA HUMBERT
Title or Position: OWNER
Credential: SLP
Phone: 240-472-1051