Organization
HYACINTH WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAWANA FENTON LPC (CEO)
(202) 906-0334
Entity
Organization
Contact information
Practice address
1224 M ST NW STE 200, WASHINGTON, DC 20005-5225
(202) 850-0641
Mailing address
2303 IRVING ST SE, WASHINGTON, DC 20020-2717
(202) 906-0334
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659861458
—
DC
Enumeration date
04/14/2020
Last updated
04/14/2020
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