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General NPI Number Information
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NPI Number | 1972901833
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Entity Type | Organization
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Legal Business Name | SERENITY WITHIN,INC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 85 BALD CYPRESS LN
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City | LEVITTOWN
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State | PA
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Zip | 19054-2801
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Country | US
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Telephone | 215-945-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 85 BALD CYPRESS LN
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City | LEVITTOWN
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State | PA
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Zip | 19054-2801
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Country | US
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Telephone | 215-945-2013
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPISTS
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Name | MRS. LORRAINE MARIE DOBERENZ
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Credential |
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Telephone | 215-945-2013
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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 | MSG005282
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License Number State | PA
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