Healthcare Provider Details

I. General information

NPI: 1881509289
Provider Name (Legal Business Name): LINDA MARIE TEDESCO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16991 BEECHWOOD AVE
BEVERLY HILLS MI
48025-5515
US

IV. Provider business mailing address

16991 BEECHWOOD AVE
BEVERLY HILLS MI
48025-5515
US

V. Phone/Fax

Practice location:
  • Phone: 248-229-1976
  • Fax:
Mailing address:
  • Phone: 248-229-1976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501014032
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: