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NPI Code Detail

MEDICARE: SOMA PSYCHE SOUL LLC

MEDICARE: SOMA PSYCHE SOUL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist

General Provider Information

NPI Number : 1710846746
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOMA PSYCHE SOUL LLC
Provider Business Mailing Address
First Line : 4317 ARENDELL ST STE 8
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-2855
Country : US
Telephone Number : 910-340-4575
Fax Number :
Provider Business Practice Location Address
First Line : 4317 ARENDELL ST STE 8
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-2855
Country : US
Telephone Number : 910-340-4575
Fax Number :
Authorized Official
Title or Position : OWNER, LMBT
Name : JENNIFER APRIL WEEKS
Credential : LMBT
Telephone Number : 910-340-4575
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “SOMA PSYCHE SOUL LLC ” Practice Location

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