Organization
BLISS BOUTIQUE 360 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAQUITA GRAHAM (CEO)
(216) 235-9063
Entity
Organization
Contact information
Practice address
3300 HIGHWAY 166, DOUGLASVILLE, GA 30135-5108
(770) 827-6397
Mailing address
3300 HIGHWAY 166, DOUGLASVILLE, GA 30135-5108
(770) 827-6397
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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