Healthcare Provider Details

I. General information

NPI: 1669099321
Provider Name (Legal Business Name): CONSONANT HEALING ASSOCIATES OF DE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 RIDGEBROOK RD STE 220
SPARKS MD
21152-9476
US

IV. Provider business mailing address

909 RIDGEBROOK RD STE 220
SPARKS MD
21152-9476
US

V. Phone/Fax

Practice location:
  • Phone: 443-383-9300
  • Fax:
Mailing address:
  • Phone: 301-928-5012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: AYEZA MOHSIN
Title or Position: OWNER
Credential: DO
Phone: 630-699-8306