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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