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Organization

FAIRY THERAPETUIC PLLC

Active
Parent organization
MYSTIC FLOW WELLNESS CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
MYSTIC FLOW WELLNESS CENTER
Authorized official
KASSI MOORE (RELAXATIONAL THERAIPST)
(540) 571-1880
Entity
Organization

Contact information

Practice address
6884 PIEDMONT CENTER PLZ, GAINESVILLE, VA 20155-4035
(571) 284-7612
Mailing address
PO BOX 31, BEALETON, VA 22712-0031
(540) 571-1880

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
163WM1400X
Nurse Massage Therapist (NMT)
171000000X
Military Health Care Provider
171400000X
Health & Wellness Coach
Primary
173C00000X
Reflexologist
225700000X
Massage Therapist
225X00000X
Occupational Therapist
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
06/10/2026
Last updated
06/10/2026
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