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General NPI Number Information
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NPI Number | 1699251819
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Entity Type | Organization
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Legal Business Name | MERAKI WELLNESS LLC
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 8987 COTSWOLD DR
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City | BURKE
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State | VA
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Zip | 22015
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Country | US
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Telephone | 202-250-0287
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Fax |
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Provider Business Mailing Address
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Address Line | 8987 COTSWOLD DR
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City | BURKE
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State | VA
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Zip | 22015-1601
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Country | US
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Telephone | 202-250-0287
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER HOWARD
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Credential | LPC
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Telephone | 703-260-6320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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