Healthcare Provider Details

I. General information

NPI: 1013867241
Provider Name (Legal Business Name): MY NATURAL ME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MARKET ST APT 315
MANASSAS PARK VA
20111-3217
US

IV. Provider business mailing address

PO BOX 303
MANASSAS VA
20108-0303
US

V. Phone/Fax

Practice location:
  • Phone: 571-288-1188
  • Fax:
Mailing address:
  • Phone: 571-288-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LILETTA HARLEM
Title or Position: PRESIDENT & FOUNDER
Credential:
Phone: 571-288-1188