Provider Demographics
NPI:1790516813
Name:SCHOLAR OF WELLNESS, LLC
Entity type:Organization
Organization Name:SCHOLAR OF WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TALIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-882-2289
Mailing Address - Street 1:4500 FORBES BLVD STE 200-1113
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6312
Mailing Address - Country:US
Mailing Address - Phone:301-882-2289
Mailing Address - Fax:
Practice Address - Street 1:4500 FORBES BLVD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6312
Practice Address - Country:US
Practice Address - Phone:301-882-2289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-10
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty