Healthcare Provider Details

I. General information

NPI: 1164080057
Provider Name (Legal Business Name): HAO HEALTH AND HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12011 LEE JACKSON MEMORIAL HWY STE 320
FAIRFAX VA
22033-3310
US

IV. Provider business mailing address

12011 LEE JACKSON MEMORIAL HWY STE 320
FAIRFAX VA
22033-3310
US

V. Phone/Fax

Practice location:
  • Phone: 703-379-7063
  • Fax: 703-763-5741
Mailing address:
  • Phone: 703-379-7063
  • Fax: 703-763-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NAN LIU
Title or Position: OFFICE MANAGER
Credential: L.AC
Phone: 571-215-7450