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General NPI Number Information
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NPI Number | 1699517052
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Entity Type | Individual
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Provider Name | RAYANDRAL N GIVENS
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Gender | Female
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 9604 ARLIE GIVENS LN
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City | SANDERSON
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State | FL
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Zip | 32087-2214
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Country | US
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Telephone | 904-275-0827
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Fax |
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Provider Business Mailing Address
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Address Line | 9671 COUNTY ROAD 127
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City | SANDERSON
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State | FL
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Zip | 32087-2275
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Country | US
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Telephone | 904-860-2061
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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 | MA99195
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License Number State | FL
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