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General NPI Number Information
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NPI Number | 1528921723
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Entity Type | Organization
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Legal Business Name | SALT AND LIGHT SALON AND SPA
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 11355 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45249-2312
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Country | US
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Telephone | 513-429-5003
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Fax |
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Provider Business Mailing Address
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Address Line | 11355 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45249-2312
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Country | US
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Telephone | 513-429-5003
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA KOCH
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Credential |
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Telephone | 513-429-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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