Provider Demographics
NPI:1861107229
Name:WWAM MOBILE MASSAGE THERAPIES, PLLC
Entity type:Organization
Organization Name:WWAM MOBILE MASSAGE THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAUSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:833-992-6772
Mailing Address - Street 1:3845 CYPRESS CREEK PKWY STE 276
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3510
Mailing Address - Country:US
Mailing Address - Phone:833-992-6772
Mailing Address - Fax:
Practice Address - Street 1:3845 CYPRESS CREEK PKWY STE 281
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3510
Practice Address - Country:US
Practice Address - Phone:833-992-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty