Provider Demographics
NPI:1285398768
Name:CHAARANI, SOURANNHA (LMBT)
Entity type:Individual
Prefix:
First Name:SOURANNHA
Middle Name:
Last Name:CHAARANI
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 MONETA LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-4154
Mailing Address - Country:US
Mailing Address - Phone:310-989-9276
Mailing Address - Fax:
Practice Address - Street 1:2044 ENERGY DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-8722
Practice Address - Country:US
Practice Address - Phone:310-989-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19606225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist