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General NPI Number Information
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NPI Number | 1073230066
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Entity Type | Individual
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Provider Name | KAYLYNN HARIAN LMT COS
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Gender | Female
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 209 12TH ST STE 211
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-6208
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Country | US
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Telephone | 682-214-7452
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Fax |
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Provider Business Mailing Address
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Address Line | 8801 N FM 620 RD APT 1227
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City | AUSTIN
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State | TX
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Zip | 78726-3523
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Country | US
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Telephone | 619-886-2194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 129109
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License Number State | TX
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