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General NPI Number Information
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NPI Number | 1659242949
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Entity Type | Organization
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Legal Business Name | EMBODIED BY ME, LLC
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 13918 SEATTLE SLEW LN
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-1538
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Country | US
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Telephone | 804-944-5695
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4093
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-0001
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Country | US
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Telephone | 804-944-5695
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTAL LA'TRESE PINCKNEY
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Credential | CTRS, C-IAYT
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Telephone | 804-944-5695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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