Provider Demographics
NPI:1598118838
Name:ERIN LIVELY
Entity Type:Organization
Organization Name:ERIN LIVELY
Other - Org Name:ERIN'S HEALING HANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BCMT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:BCMT, MMP
Authorized Official - Phone:804-901-2181
Mailing Address - Street 1:6767 FOREST HILL AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1856
Mailing Address - Country:US
Mailing Address - Phone:804-901-2181
Mailing Address - Fax:
Practice Address - Street 1:6767 FOREST HILL AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1856
Practice Address - Country:US
Practice Address - Phone:804-901-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019004616225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty