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General NPI Number Information
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NPI Number | 1033737838
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Entity Type | Organization
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Legal Business Name | HARBOR HOLISTIC HEALING, LLC
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 86 KENNEDY DR
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City | SEVERNA PARK
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State | MD
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Zip | 21146-3008
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Country | US
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Telephone | 443-474-3631
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Fax | 410-874-0131
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Provider Business Mailing Address
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Address Line | 85 TWO RIVERS DR
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City | EDGEWATER
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State | MD
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Zip | 21037-2677
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Country | US
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Telephone | 410-855-3144
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Fax | 410-874-0131
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | LYDIA ELLEN WAINWRIGHT
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Credential | M.AC, LIC.AC
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Telephone | 443-474-3631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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