Healthcare Provider Details

I. General information

NPI: 1912548314
Provider Name (Legal Business Name): ARAYA HOLISTIC PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23330 FREDERICK RD FL 2
CLARKSBURG MD
20871-9704
US

IV. Provider business mailing address

20302 SCENERY DR
GERMANTOWN MD
20876-6036
US

V. Phone/Fax

Practice location:
  • Phone: 240-702-6413
  • Fax:
Mailing address:
  • Phone: 240-654-2608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: KHANITA SUVARNASUDDHI
Title or Position: OWNER
Credential: DC, L.AC
Phone: 240-654-2608