Healthcare Provider Details

I. General information

NPI: 1629907456
Provider Name (Legal Business Name): LEONA PYMM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 S MCCLINTOCK DR STE 105
TEMPE AZ
85284-4553
US

IV. Provider business mailing address

1145 E 3RD ST
MESA AZ
85203-8003
US

V. Phone/Fax

Practice location:
  • Phone: 480-652-6658
  • Fax:
Mailing address:
  • Phone: 480-652-6658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-29194
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: