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General NPI Number Information
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NPI Number | 1447669734
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Entity Type | Organization
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Legal Business Name | DREAMSCAPE MASSAGE LLC
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1540 S MCCALL RD
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City | ENGLEWOOD
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State | FL
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Zip | 34223-4846
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Country | US
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Telephone | 941-681-0039
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Fax | 941-460-0935
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Provider Business Mailing Address
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Address Line | 1 DOVER DR
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City | ENGLEWOOD
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State | FL
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Zip | 34223-4637
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Country | US
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Telephone | 941-681-0039
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MRS. DEBRA K SPECHT
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Credential | LMT
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Telephone | 941-681-0039
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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 | 15766
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA86858
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License Number State | FL
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