# ETHEREAL WELLNESS CLINIC LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215806427
- **Authorized official:** YANI MAO (OWNER)
- **Authorized official phone:** (443) 398-7018

## Contact information

- **Practice address:** 1645 LIBERTY RD STE 102, SYKESVILLE, MD 21784-6537
- **Practice address phone:** (443) 398-7018
- **Mailing address:** 1645 LIBERTY RD STE 102, SYKESVILLE, MD 21784-6537
- **Mailing address phone:** (443) 398-7018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2025
- **Last updated:** 11/04/2025