Provider Demographics
NPI:1649049776
Name:NK DANCE SERVICES LLC
Entity type:Organization
Organization Name:NK DANCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAOSOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:EZIGBOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-370-4485
Mailing Address - Street 1:8455 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:STE 3, #574
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:443-574-4753
Mailing Address - Fax:
Practice Address - Street 1:5621 OLD FREDERICK RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1554
Practice Address - Country:US
Practice Address - Phone:443-574-4753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty