Healthcare Provider Details

I. General information

NPI: 1851205413
Provider Name (Legal Business Name): JULIA ANDRADE ROCHA SMOOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 THAYER AVE STE 105
SILVER SPRING MD
20910-5734
US

IV. Provider business mailing address

1704 HOPEFIELD RD
SILVER SPRING MD
20905-4112
US

V. Phone/Fax

Practice location:
  • Phone: 443-977-0095
  • Fax:
Mailing address:
  • Phone: 443-977-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM07248
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: