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Organization

JAE LLC

Active
Other names
The Happy Mama Place
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JESSICA ANN ENRIQUEZ LMT (DOULA/LICENSED MASSAGE THERAPIST)
(570) 299-9247
Entity
Organization

Contact information

Practice address
512 NORTHHAMPTON STREET, EDWARDSVILLE, PA 18704
(570) 212-9520
Mailing address
827 STOCKTON MOUNTAIN RD, BEAVER MEADOWS, PA 18216-6505
(570) 299-9246

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MSG006829
PA
374J00000X
Doula
Primary

Other

Enumeration date
12/28/2016
Last updated
12/28/2016
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