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Organization
ENERGY BASE LLC
Active
Organization
ENERGY BASE LLC
Active
Other names
Sage Chi Integrative Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIAA C. HARTLEY D.AC, L.AC (OWNER)
(301) 580-4585
Entity
Organization
Contact information
Practice address
1629 CROFTON CTR STE 18, CROFTON, MD 21114-1318
(301) 580-4585
(240) 366-5954
Mailing address
1123 STATE ROUTE 3 N STE 282, GAMBRILLS, MD 21054-1715
(301) 580-4585
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
764013700
—
MD
Enumeration date
04/12/2021
Last updated
09/28/2021
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