Healthcare Provider Details

I. General information

NPI: 1336757558
Provider Name (Legal Business Name): Y.O.U HOLISTIC HEALTH AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 WYNDHAM CIR APT 1195
ALEXANDRIA VA
22302-4316
US

IV. Provider business mailing address

6525 CLUSTER PINE CT
WALDORF MD
20603-6706
US

V. Phone/Fax

Practice location:
  • Phone: 240-270-3636
  • Fax:
Mailing address:
  • Phone: 240-270-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TASHA SMITH
Title or Position: CO-OWNER
Credential:
Phone: 240-270-3636