=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548469943
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING HANDS THERAPY,INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2007
-----------------------------------------------------
Last Update Date | 07/16/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11442 RIDGE RD
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34654-5310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-278-5690
-----------------------------------------------------
Fax | 727-844-3193
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11442 RIDGE RD
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34654-5310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-278-5690
-----------------------------------------------------
Fax | 727-844-3193
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | MRS. LINDA LEE GAGNON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-844-3193
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------