MIRAGE THERAPEUTIC TOUCH (NPI# 1336591999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336591999 |
| Entity Type | Organization |
| Organization Name | MIRAGE THERAPEUTIC TOUCH |
| Practice Address |
19603 Moenart St Detroit MI 48234-2309 |
| Practice Telephone | 2483465948 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |
| Authorized Official Name | LYNNETTE MARSHALL-SIMS (MASSAGE THERAPIST) |
| Authorized Official Telephone | 2483465948 |
| Authorized Official Credential | BCTMB, LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
19603 MOENART ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48234-2309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205332483 | Bryce Xavier Bredell | Student in an Organized Health Care Education/Training Program | 6071 E Outer Dr, Detroit, MI 48234 | 2018-04-05 |
| 1538668595 | Constance Durden | Social Worker | 19940 Conant Suite B, Detroit, MI 48234 | 2018-02-06 |
| 1891217717 | Donald Williams | Case Manager/Care Coordinator | 19133 Hasse, Detroit, MI 48234 | 2017-07-12 |
| 1063865830 | Gloria A. Love | Psychologist | 19677 Revere, Detroit, MI 48234 | 2016-07-18 |
| 1972977429 | Conant Garden Dental Center Dds PC | Dentist | 2430 E Seven Mile, Suite 6, Detroit, MI 48234 | 2015-11-20 |
| 1861878787 | Kenyatta Philips | Chore Provider | 20119 Helen St, Detroit, MI - MICHIGAN 48234 | 2015-08-03 |
| 1083977144 | Edward Powell | Counselor | 19436 Packard Street, Detroit, MI 48234 | 2012-06-22 |
| 1487931325 | Sonia Renee George | Case Manager/Care Coordinator | 8331 Yolanda St., Detroit, MI 48234 | 2011-11-07 |
| 1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
| 1558662742 | Tenille Daniel | Home Health | 17210 Runyon, Detroit, MI 48234 | 2010-11-04 |
| Find all providers in zip 48234 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302493 | Irene Dooley | Massage Therapist | 544 E Kirby St, Detroit, MI 48202-4121 | 2020-09-28 |
| 1841806338 | Kaiesha Laszetta Rivers | Massage Therapist | 12750 Filbert St, Detroit, MI 48205-3937 | 2020-09-20 |
| 1770198640 | Amira Mathiea | Massage Therapist | 16528 Salem St, Detroit, MI 48219-3667 | 2020-09-08 |
| 1568077410 | Roberta Reynolds-hill | Massage Therapist | 15791 Mansfield St, Detroit, MI 48227-1906 | 2020-09-08 |
| 1639782436 | Paige Currier | Massage Therapist | 4070 Leslie St, Detroit, MI 48238-3243 | 2020-08-31 |
| 1154931228 | Golden Touch, LLC | Massage Therapist | 8325 E Jefferson Ave, Detroit, MI 48214-2797 | 2020-08-04 |
| 1912539636 | Diana Pope | Massage Therapist | 6771 Iowa St, Detroit, MI 48212-1423 | 2020-02-11 |
| 1710523865 | Erica Siobhan Longs | Massage Therapist | 15848 Cheyenne St, Detroit, MI 48227-3614 | 2019-11-25 |
| 1851954408 | Beverly Foster-maxey | Massage Therapist | 17460 Salem St, Detroit, MI 48219-5802 | 2019-04-19 |
| 1104392653 | Emanuel Borden IIi | Massage Therapist | 12020 Lakepointe St, Detroit, MI 48224-4110 | 2018-10-22 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.