Healthcare Provider Details

I. General information

NPI: 1245629336
Provider Name (Legal Business Name): VEDA JOHNSON N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9811 GREENBELT RD STE 207
LANHAM MD
20706-6241
US

IV. Provider business mailing address

9811 GREENBELT RD STE 207
LANHAM MD
20706-6241
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-2621
  • Fax: 301-552-2621
Mailing address:
  • Phone: 301-552-2621
  • Fax: 301-552-2621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: