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Organization

FRUITFUL VIBRATIONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IESHA JACKSON LMT (MEMBER)
(716) 939-7222
Entity
Organization

Contact information

Practice address
391 WASHINGTON ST, BUFFALO, NY 14203-2108
(716) 939-7222
Mailing address
224 BLAINE AVE, BUFFALO, NY 14208-1018
(716) 939-7222

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
032732
NY OFFICE OF PROFESSIONS MASSAGE THERAPY LICENSE
NY
Enumeration date
12/13/2022
Last updated
03/04/2026
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