Provider Demographics
NPI: | 1073082624 |
---|---|
Name: | A BIT OF BLISS THERAPY, INC |
Entity type: | Organization |
Organization Name: | A BIT OF BLISS THERAPY, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/LICENSED MASSAGE THERAPIST |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | APRIL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GUILHERME |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMT |
Authorized Official - Phone: | 570-817-8847 |
Mailing Address - Street 1: | 156 COMANCHE TRL |
Mailing Address - Street 2: | |
Mailing Address - City: | POCONO LAKE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18347-7871 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 570-817-9058 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 965 ROUTE 940 STE 103 |
Practice Address - Street 2: | |
Practice Address - City: | POCONO LAKE |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18347-8205 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-817-8847 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-11-13 |
Last Update Date: | 2018-11-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | Group - Single Specialty |