Provider Demographics
NPI:1861996969
Name:TAILORED TOUCH MASSAGE THERAPY LLC
Entity type:Organization
Organization Name:TAILORED TOUCH MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLADES-BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT MMP
Authorized Official - Phone:818-297-6268
Mailing Address - Street 1:22267 SUMMIT VUE LN
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7248
Mailing Address - Country:US
Mailing Address - Phone:818-297-6268
Mailing Address - Fax:747-226-1444
Practice Address - Street 1:22267 SUMMIT VUE LN
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7248
Practice Address - Country:US
Practice Address - Phone:818-297-6268
Practice Address - Fax:747-226-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3008225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty