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General NPI Number Information
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NPI Number | 1457244089
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Entity Type | Organization
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Legal Business Name | HEALING WELLNESS MASSAGE LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 8338 VETERANS HWY STE 205B
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2637
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Country | US
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Telephone | 410-507-7158
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Fax | 410-544-5180
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Provider Business Mailing Address
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Address Line | 55 STRATFORD DR
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City | SEVERNA PARK
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State | MD
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Zip | 21146-1803
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Country | US
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Telephone | 410-507-7158
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST/OWNER
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Name | SUSAN LYNN MCCLARE
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Credential | LMT
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Telephone | 410-507-7158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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