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General NPI Number Information
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NPI Number | 1568811966
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Entity Type | Organization
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Legal Business Name | HONOR YOUR BODY WELLNESS
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 2882 W LIBERTY AVE FL 2
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City | PITTSBURGH
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State | PA
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Zip | 15216
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Country | US
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Telephone | 412-999-4612
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Fax |
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Provider Business Mailing Address
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Address Line | 2882 W LIBERTY AVE FL 2
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City | PITTSBURGH
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State | PA
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Zip | 15216-2622
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Country | US
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Telephone | 412-999-4612
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Fax |
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Authorized Official
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Title or Position | OWNER, LMT, MMP, YT
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Name | CARRIE FAITH SHALEY
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Credential | LMT
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Telephone | 412-999-4612
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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 | MSG007904
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License Number State | PA
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