Healthcare Provider Details

I. General information

NPI: 1841102738
Provider Name (Legal Business Name): LAVENDER HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 GREENVIEW DR STE 206
LAUREL MD
20708-4249
US

IV. Provider business mailing address

725 FARAWAY CT
BOWIE MD
20721-1824
US

V. Phone/Fax

Practice location:
  • Phone: 240-479-8526
  • Fax:
Mailing address:
  • Phone: 240-479-8526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: TIANA JANAY LAVENDER
Title or Position: OWNER
Credential:
Phone: 202-384-3566