| NPI | 1710698519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IESHA JACKSON Member 716-939-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 374J00000X Doula |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2025-01-25 |