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General NPI Number Information
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NPI Number | 1194433862
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Entity Type | Organization
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Legal Business Name | RELAXED THERAPY PLLC
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 500 S MAIN ST STE 113
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City | MOORESVILLE
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State | NC
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Zip | 28115-3228
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Country | US
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Telephone | 704-224-9506
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 CRESCENT RD
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City | SALISBURY
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State | NC
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Zip | 28146-0303
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Country | US
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Telephone | 704-224-9506
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. MELODY ANN MATTINGLY
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Credential | NCC, LCMHC, LCAS
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Telephone | 704-224-9506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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