NPI 1255043154 · live from the CMS NPI Registry
Leonnie Brathwaite, LMBT, CT
Massage Therapist in Raleigh, NC. National Provider Identifier 1255043154, active.
NPI record
| NPI | 1255043154 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 10931 Raven Ridge Rd Ste 103, Raleigh, NC 27614 |
| Practice phone | 919-865-6900 |
| Mailing address | 4205 Cobia Ct Apt A, Raleigh, NC 27604 |
| Enumerated | December 22, 2022 |
| Last updated | December 22, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 14883 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.