Provider Demographics
NPI:1669647947
Name:A HEALING ENERGY MASSAGE
Entity Type:Organization
Organization Name:A HEALING ENERGY MASSAGE
Other - Org Name:JANET A. LLERENA, LMT
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:LLERENA
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:239-947-9392
Mailing Address - Street 1:8850 TERRENE CT
Mailing Address - Street 2:SUITES 102 & 103
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-9525
Mailing Address - Country:US
Mailing Address - Phone:239-947-9392
Mailing Address - Fax:239-947-9392
Practice Address - Street 1:8850 TERRENE CT
Practice Address - Street 2:SUITES 102 & 103
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-9525
Practice Address - Country:US
Practice Address - Phone:239-947-9392
Practice Address - Fax:239-947-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM21024225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty