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General NPI Number Information
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NPI Number | 1760171490
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Entity Type | Individual
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Provider Name | DAYSHA SHALOM WHITE LMT
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Gender | Female
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 700 BRYDEN RD STE 204
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City | COLUMBUS
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State | OH
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Zip | 43215-4839
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Country | US
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Telephone | 404-939-7401
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Fax |
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Provider Business Mailing Address
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Address Line | 3404 RED CEDAR CT
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City | GROVE CITY
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State | OH
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Zip | 43123-9790
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Country | US
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Telephone | 404-435-3418
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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 | 33.025477
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License Number State | OH
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