Healthcare Provider Details

I. General information

NPI: 1023954401
Provider Name (Legal Business Name): WELLZA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26083 HUNTWICK GLEN SQUARE
ALDIE VA
20105
US

IV. Provider business mailing address

26083 HUNTWICK GLEN SQ
ALDIE VA
20105-5716
US

V. Phone/Fax

Practice location:
  • Phone: 636-713-4151
  • Fax:
Mailing address:
  • Phone: 636-713-4151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARITHA RAMASAMY
Title or Position: OWNER
Credential: DPT
Phone: 646-713-4151