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General NPI Number Information
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NPI Number | 1659856748
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Entity Type | Individual
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Provider Name | HEATHER M SWEENEY CMT
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 2701 OCEAN PARK BLVD STE 111
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City | SANTA MONICA
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State | CA
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Zip | 90405-5200
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Country | US
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Telephone | 424-410-9377
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Fax |
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Provider Business Mailing Address
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Address Line | 1507 PACIFIC ST
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City | SANTA MONICA
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State | CA
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Zip | 90405-1619
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Country | US
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Telephone | 310-948-0723
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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 | 33675
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License Number State | CA
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