Provider Demographics
NPI:1144940024
Name:CUSTOMIZE ME, LLC.
Entity type:Organization
Organization Name:CUSTOMIZE ME, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HYPNOTHERAPIST / PRACTIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BLAISE
Authorized Official - Last Name:MCDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:CHT
Authorized Official - Phone:609-865-7332
Mailing Address - Street 1:3 MINUTE MAN CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3271
Mailing Address - Country:US
Mailing Address - Phone:908-812-1908
Mailing Address - Fax:
Practice Address - Street 1:3 MINUTE MAN CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3271
Practice Address - Country:US
Practice Address - Phone:908-812-1908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty