Healthcare Provider Details

I. General information

NPI: 1255264347
Provider Name (Legal Business Name): SHEREE TOMASELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 N PITT ST
ALEXANDRIA VA
22314-5600
US

IV. Provider business mailing address

14008 ALTUS CT
WOODBRIDGE VA
22191-3407
US

V. Phone/Fax

Practice location:
  • Phone: 833-724-1512
  • Fax:
Mailing address:
  • Phone: 571-575-3546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019020881
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: