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General NPI Number Information
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NPI Number | 1538985908
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Entity Type | Individual
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Provider Name | SHALA A LOVETT MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1697 WHITNEY AVE
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City | HAMDEN
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State | CT
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Zip | 06517-1936
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Country | US
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Telephone | 203-491-8982
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Fax |
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Provider Business Mailing Address
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Address Line | 171 SPRINGDALE AVE
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City | MERIDEN
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State | CT
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Zip | 06451-2936
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Country | US
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Telephone | 203-721-1554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 11325
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License Number State | CT
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