Healthcare Provider Details

I. General information

NPI: 1093274490
Provider Name (Legal Business Name): CRAVE THERAPEUTIC MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10203 GLEN WAY STE B1
FORT WASHINGTON MD
20744-2549
US

IV. Provider business mailing address

10203 GLEN WAY STE B1
FORT WASHINGTON MD
20744-2549
US

V. Phone/Fax

Practice location:
  • Phone: 202-688-5996
  • Fax:
Mailing address:
  • Phone: 202-688-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: NAJMAH BASS
Title or Position: THERAPIST
Credential:
Phone: 646-391-9516