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General NPI Number Information
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NPI Number | 1306644232
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Entity Type | Individual
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Provider Name | JACQUELINE MCDANIEL MCSWAIN LMBT MLD-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 302 W WARREN ST
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City | SHELBY
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State | NC
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Zip | 28150-5328
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Country | US
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Telephone | 980-473-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 309 WEBB RD
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City | SHELBY
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State | NC
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Zip | 28152-6004
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Country | US
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Telephone | 704-691-4871
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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 | 21794
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License Number State | NC
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