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General NPI Number Information
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NPI Number | 1427315084
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Entity Type | Organization
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Legal Business Name | HEALING HEANDS REIKI AND MASSAGE, LLC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 429 B ST
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City | IDAHO FALLS
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State | ID
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Zip | 83402-3544
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Country | US
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Telephone | 208-542-5446
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Fax |
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Provider Business Mailing Address
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Address Line | 429 B ST
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City | IDAHO FALLS
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State | ID
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Zip | 83402-3544
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Country | US
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Telephone | 208-542-5446
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | MRS. DIXIE BLAIN
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Credential |
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Telephone | 208-528-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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