Healthcare Provider Details

I. General information

NPI: 1013717123
Provider Name (Legal Business Name): WHOLE CHILD THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10322 VISTA MEADOW WAY
LANHAM MD
20706-2894
US

IV. Provider business mailing address

10322 VISTA MEADOW WAY
LANHAM MD
20706-2894
US

V. Phone/Fax

Practice location:
  • Phone: 301-532-6373
  • Fax:
Mailing address:
  • Phone: 301-532-6373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ANNA LIMA
Title or Position: CEO
Credential: MA-SLP
Phone: 301-532-6373