Provider Demographics
NPI:1043561160
Name:DREAMS DAY SPA
Entity Type:Organization
Organization Name:DREAMS DAY SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-522-0316
Mailing Address - Street 1:115 BULIFANTS BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5720
Mailing Address - Country:US
Mailing Address - Phone:757-229-1236
Mailing Address - Fax:757-229-1237
Practice Address - Street 1:115 BULIFANTS BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5720
Practice Address - Country:US
Practice Address - Phone:757-229-1236
Practice Address - Fax:757-229-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA023957174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty