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General NPI Number Information
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NPI Number | 1477296382
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Entity Type | Organization
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Legal Business Name | SOUND MIND AND BODY WELLNESS
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 6860 66TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5036
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Country | US
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Telephone | 727-373-6732
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Fax |
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Provider Business Mailing Address
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Address Line | 6860 66TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5036
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Country | US
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Telephone | 727-373-6732
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | MRS. JEID N LEWIS-JOLLEY HUNTER
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Credential | COO/LMT
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Telephone | 727-373-6732
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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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