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General NPI Number Information
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NPI Number | 1396563193
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Entity Type | Organization
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Legal Business Name | ARTSY HEALER LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 825 S. BROADWAY C/O MANDALA
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City | BOULDER
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State | CO
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Zip | 80305
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Country | US
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Telephone | 303-859-2441
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Fax |
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Provider Business Mailing Address
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Address Line | 825 S. BROADWAY C/O MANDALA
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City | BOULDER
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State | CO
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Zip | 80305
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Country | US
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Telephone | 303-859-2441
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Fax |
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Authorized Official
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Title or Position | OWNER, MASSAGE THERAPIST
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Name | CRISTA DELAGARZA
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Credential | LMT, BCTMB
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Telephone | 303-859-2441
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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 |
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License Number State |
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