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General NPI Number Information
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NPI Number | 1184437543
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Entity Type | Individual
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Provider Name | TANYA BESAW LMBT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 5555 WALDOS BEACH RD STE A
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-5507
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Country | US
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Telephone | 910-818-3818
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Fax |
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Provider Business Mailing Address
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Address Line | 2816 BEARS DEN WAY
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City | FAYETTEVILLE
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State | NC
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Zip | 28312-9602
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Country | US
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Telephone | 910-305-9076
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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 | 18260
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License Number State | NC
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