Provider Demographics
NPI:1114203593
Name:PEACE OF MIND THERAPY, LLC
Entity Type:Organization
Organization Name:PEACE OF MIND THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOVACH
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:609-707-7869
Mailing Address - Street 1:106 CLEMENT DR
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2606
Mailing Address - Country:US
Mailing Address - Phone:609-707-7869
Mailing Address - Fax:
Practice Address - Street 1:151 FRIES MILL RD
Practice Address - Street 2:SUITE 305
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2016
Practice Address - Country:US
Practice Address - Phone:609-707-7869
Practice Address - Fax:856-302-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00254700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty