Provider Demographics
NPI:1477296382
Name:SOUND MIND AND BODY WELLNESS
Entity Type:Organization
Organization Name:SOUND MIND AND BODY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEID
Authorized Official - Middle Name:N
Authorized Official - Last Name:LEWIS-JOLLEY HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:COO/LMT
Authorized Official - Phone:727-373-6732
Mailing Address - Street 1:6860 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-5036
Mailing Address - Country:US
Mailing Address - Phone:727-373-6732
Mailing Address - Fax:
Practice Address - Street 1:6860 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5036
Practice Address - Country:US
Practice Address - Phone:727-373-6732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty