Healthcare Provider Details

I. General information

NPI: 1720845530
Provider Name (Legal Business Name): REUBEN SCHOOLER LMBT, CLT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 HILL ST
RALEIGH NC
27610-2227
US

IV. Provider business mailing address

832 NIGHTSHADE WAY
RALEIGH NC
27610-4980
US

V. Phone/Fax

Practice location:
  • Phone: 919-561-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number07808
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: