Healthcare Provider Details

I. General information

NPI: 1679436554
Provider Name (Legal Business Name): TRUE MASSAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2598 PASS RD STE C
BILOXI MS
39531-2713
US

IV. Provider business mailing address

113 DAVID ST
GULFPORT MS
39503-3411
US

V. Phone/Fax

Practice location:
  • Phone: 769-926-0621
  • Fax:
Mailing address:
  • Phone: 228-547-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHAUNACEY VALDEZ
Title or Position: OWNER
Credential: LMT
Phone: 228-547-8436