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General NPI Number Information
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NPI Number | 1538772728
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Entity Type | Organization
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Legal Business Name | A GODDESSES TOUCH
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 5840 GIBBONS DR STE C
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City | CARMICHAEL
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State | CA
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Zip | 95608-6903
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Country | US
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Telephone | 916-515-8523
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 294044
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City | SACRAMENTO
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State | CA
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Zip | 95829-4044
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Country | US
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Telephone | 916-591-6334
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. JUARIA NICOLE PERKINS
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Credential | LMT
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Telephone | 916-515-8523
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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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