Provider Demographics
NPI:1851803092
Name:HAMLIN, TEENA (LMT, BCMT)
Entity type:Individual
Prefix:
First Name:TEENA
Middle Name:
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:LMT, BCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3124 FRIARS WALK LN
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2596
Mailing Address - Country:US
Mailing Address - Phone:804-332-2097
Mailing Address - Fax:
Practice Address - Street 1:400 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2707
Practice Address - Country:US
Practice Address - Phone:804-332-2097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 173C00000X, 225800000X
VA0019010236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach
No173C00000XOther Service ProvidersReflexologist
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist