# RESTORATIVE THERAPY & WELLNESS SPA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225752165
- **Authorized official:** LATWANYA JANEA TRAYLOR NP (MANAGING MEMBER)
- **Authorized official phone:** (214) 384-6466

## Contact information

- **Practice address:** 2100 N HWY 360 STE 2007B, GRAND PRAIRIE, TX 75050-1045
- **Practice address phone:** (214) 384-6466
- **Mailing address:** 2100 N HWY 360 STE 2007B, GRAND PRAIRIE, TX 75050-1045
- **Mailing address phone:** (214) 384-6466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2022
- **Last updated:** 10/03/2022