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General NPI Number Information
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NPI Number | 1295490076
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Entity Type | Individual
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Provider Name | MICHELLE HOPE LMT
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Gender | Female
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | C/O 140 JULIA STE
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168
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Country | US
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Telephone | 862-755-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 630 ELM AVE
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City | HOLLY HILL
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State | FL
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Zip | 32117-3360
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Country | US
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Telephone | 862-755-9866
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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 | MA90781
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License Number State | FL
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